ArticleClinical cardiology2022
Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients.
Article in Clinical cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 41 citations in OpenAlex.
- Trial
- Very early invasive strategy in higher risk non-ST-elevation acute coronary syndrome: the RAPID NSTEMI trial.Heart (British Cardiac Society) · 2024Trial
- Machine Learning-Based Risk Prediction of In-Hospital Mortality in Patients With Non-ST-Elevation Acute Coronary Syndrome at Various Stages of the Diagnostic Process: Observational Study.JMIR medical informatics · 2026Observational
- Evidence for Electrocardiographic Patterns Identifying Acute Coronary Occlusion in Non-ST-Elevation Acute Coronary Syndromes: A Scoping Review.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- OMI: time for early recognition and management of acute coronary occlusion.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026Article
- Review
- Impact of the risk-treatment paradox on in-hospital and long-term outcomes in patients with very high-risk non-ST-elevation acute coronary syndrome.The Indian journal of medical research · 2026Review
- Article
- Low estimated glucose disposal rate predicts high residual syntax score in non-diabetic ST-elevation myocardial infarction patients.Diabetology & metabolic syndrome · 2025Article
- A Diagnostic Paradigm Shift in Acute Myocardial Infarction: Rationale and Design of the DIFOCCULT-3 Trial.JACC. Advances · 2025Article
- Article
- Occlusion myocardial infarction: a revolution in acute coronary syndrome.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2025Article
- Reply: Circumflex Artery, Missed Occlusions, and Paradigm Shift.JACC. Advances · 2025Article
- Types and hospital manifestation of the "risk-treatment" paradox in non-ST-elevation acute coronary syndrome: the regional vascular centre experience.BMC cardiovascular disorders · 2025Observational
- Impact of treatment management on the hospital stay in patients with acute coronary syndrome.BMC cardiovascular disorders · 2024Article
- From ST-Segment Elevation MI to Occlusion MI: The New Paradigm Shift in Acute Myocardial Infarction.JACC. Advances · 2024Review
- Optimal timing of percutaneous coronary intervention in elderly patients with acute ST-segment elevation myocardial infarction presenting late.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2024Article
- Beyond STEMI-NSTEMI Paradigm: Dante Pazzanese's Proposal for Occlusion Myocardial Infarction Diagnosis.Arquivos brasileiros de cardiologia · 2024Review
- Review
- Immediate and early percutaneous coronary intervention in very high-risk and high-risk non-ST segment elevation myocardial infarction patients.Clinical cardiology · 2022Article
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Authors and funding
15 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe European Society of Cardiology (ESC) guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation (non-ST-segment elevation myocardial infarction [NSTEMI]) has recommended immediate (<2 h) percutaneous coronary intervention (PCI) in very-high risk patients and early (<24 h) PCI in high-risk patients. HYPOTHESIS: To examine the ESC NSTEMI guidelines adherence in a nationwide survey in Israel using the Acute Coronary Syndrome Israeli Survey (ACSIS). We hypothesized that adherence to the guidlines' recommnded PCI timing in NSTEMI pateints will be inadequate, partly due to the inconsistent evidence regarding its effect on clinical outcomes.
methodsAll NSTEMI patients who underwent PCI during the ACSIS surveys in 2016 and 2018 were included in the analysis.
resultsOut of 1793 NSTEMI patients, 1643 (92%) patients underwent PCI, and door to balloon time was documented in 1078 of them. One hundred and fifty-six (14.5%) patients and 922 (85.5%) patients were defined as very high-risk and high-risk NSTEMI patients, respectively. Of the very high-risk NSTEMI patients, only 10 (6.4%) underwent immediate coronary angiography, and 50 (32.1%) underwent early coronary angiography. Acute heart failure 139 (89.1%) was the main reason for including NSTEMI patients in the very high-risk category. Of the high-risk patients, early coronary angiography was performed in only 405 (43.9%) patients. Patients in whom coronary angiography was postponed were older and had more comorbidities.
conclusionsDespite guidelines recommendations for immediate and early PCI in very high-risk and high-risk NSTEMI patients, respectively, most patients do not undergo immediate or early PCI according to contemporary guidelines. Further studies are needed to better understand the reasons for guidelines' nonadherence in those high-risk patients.
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