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Current Opinion in Cardiology:
doi: 10.1097/HCO.0b013e328312c327
Ischemic heart disease: Edited by Peter H. Stone

Time to coronary angiography in patients with non-ST-segment elevation acute coronary syndrome: how fast should patients go to the catheterization laboratory?

Tricoci, Pierluigi

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Purpose of review: This review describes available data on the optimal timing of an early invasive strategy in patients with high-risk non-ST-segment elevation acute coronary syndromes, along with challenges with type of studies. We also discuss the implication of timing in the overall management of the non-ST-segment elevation acute coronary syndrome patients.

Recent findings: The issue of timing of the coronary angiography has been addressed mainly with observational analyses. The only, small, randomized clinical trial, the Intracoronary Stenting With Antithrombotic Regimen Cooling-Off, indicated a superiority of an expedited approach compared with a much deferred angiography. A recent observational analysis adopting special statistical methodologies confirmed the finding of the Intracoronary Stenting With Antithrombotic Regimen Cooling-Off trial in patients undergoing an early invasive strategy in the first 48 h of presentation.

Summary: Current evidence is not sufficient to recommend the use of a routine expedite invasive strategy but suggests that it may be a viable approach.

© 2008 Lippincott Williams & Wilkins, Inc.


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