SynthesisEuropean heart journal2022
Timing of invasive strategy in non-ST-elevation acute coronary syndrome: a meta-analysis of randomized controlled trials.
Synthesis in European heart journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07204847 (Prognostic Impact of Guideline-recommended Timing for Invasive Strategy in NSTEMI), which is not on this map. Cited by 32 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prognostic Impact of Guideline-recommended Timing for Invasive Strategy in NSTEMI: a Prospective Real-world Study
Who cites it
32 citing papers in PubMed.
- Trial
- Very early invasive strategy in higher risk non-ST-elevation acute coronary syndrome: the RAPID NSTEMI trial.Heart (British Cardiac Society) · 2024Trial
- Effectiveness of GRACE risk score in patients admitted to hospital with non-ST elevation acute coronary syndrome (UKGRIS): parallel group cluster randomised controlled trial.BMJ (Clinical research ed.) · 2023Trial
- Clinical outcomes of invasive versus conservative strategies for very high-risk patients with non-ST-elevation acute coronary syndrome: an observational cohort study in a real-world population of China.EClinicalMedicine · 2026Article
- Helicopter emergency medical services for interfacility transfers: an Italian expert consensus.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Periprocedural Myocardial Infarction: Do We Need an Updated Definition?Journal of cardiovascular development and disease · 2026Review
- 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
- Triage of Stable Patients With Suspected Acute Myocardial Infarction and Left Bundle Branch Block: A Multicenter, Propensity Score-Matched Analysis.Deutsches Arzteblatt international · 2025Observational
- Early Invasive Strategy in Non-ST-Elevation Acute Coronary Syndrome With Congestive Heart Failure - A Systematic Review and Meta-Analysis.Circulation reports · 2025Article
- Age and sex differences in the efficacy of early invasive strategy for non-ST-elevation acute coronary syndrome: A comparative analysis in stable patients.American journal of preventive cardiology · 2025Article
- Sex differences based on the timing of invasive management among patients with non-ST-elevation acute coronary syndrome: an individual patient data meta-analysis.European heart journal open · 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
- Proenkephalin improves cardio-renal risk prediction in acute coronary syndromes: the KID-ACS score.European heart journal · 2025Article
- Identification of NSTE-ACS patients with totally occluded infarct-related artery: the role of the SAVE risk score in improved risk stratification.Frontiers in cardiovascular medicine · 2025Article
- Delay to ICA for patients with NSTEMI admitted to hospitals without cardiac catheterisation facilities in SE Scotland.The British journal of cardiology · 2025Article
- Early coronary revascularization among 'stable' patients with non-ST-segment elevation acute coronary syndromes: the role of diabetes and age.Cardiovascular research · 2024Article
- Article
- Impact of treatment management on the hospital stay in patients with acute coronary syndrome.BMC cardiovascular disorders · 2024Article
- Improving the non-ST-segment elevation acute coronary syndrome (NSTEACS) pathway using quality improvement methodology.BMJ open quality · 2024Article
- 2023 European Society of Cardiology guidelines for the management of acute coronary syndromes : Statement of endorsement by the NVVC.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2024Review
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe optimal timing of an invasive strategy (IS) in non-ST-elevation acute coronary syndrome (NSTE-ACS) is controversial. Recent randomized controlled trials (RCTs) and long-term follow-up data have yet to be included in a contemporary meta-analysis. METHODS AND
resultsA systematic review of RCTs that compared an early IS vs. delayed IS for NSTE-ACS was conducted by searching MEDLINE, Embase, and Cochrane Central Register of Controlled Trials. A meta-analysis was performed by pooling relative risks (RRs) using a random-effects model. The primary outcome was all-cause mortality. Secondary outcomes included myocardial infarction (MI), recurrent ischaemia, admission for heart failure (HF), repeat re-vascularization, major bleeding, stroke, and length of hospital stay. This study was registered with PROSPERO (CRD42021246131). Seventeen RCTs with outcome data from 10 209 patients were included. No significant differences in risk for all-cause mortality [RR: 0.90, 95% confidence interval (CI): 0.78-1.04], MI (RR: 0.86, 95% CI: 0.63-1.16), admission for HF (RR: 0.66, 95% CI: 0.43-1.03), repeat re-vascularization (RR: 1.04, 95% CI: 0.88-1.23), major bleeding (RR: 0.86, 95% CI: 0.68-1.09), or stroke (RR: 0.95, 95% CI: 0.59-1.54) were observed. Recurrent ischaemia (RR: 0.57, 95% CI: 0.40-0.81) and length of stay (median difference: -22 h, 95% CI: -36.7 to -7.5 h) were reduced with an early IS.
conclusionIn all-comers with NSTE-ACS, an early IS does not reduce all-cause mortality, MI, admission for HF, repeat re-vascularization, or increase major bleeding or stroke when compared with a delayed IS. Risk of recurrent ischaemia and length of stay are significantly reduced with an early IS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.