Observational studyBMC cardiovascular disorders2025
Types and hospital manifestation of the "risk-treatment" paradox in non-ST-elevation acute coronary syndrome: the regional vascular centre experience.
Observational study in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is reason to believe that unfavorable outcomes of non-ST-elevation acute coronary syndrome (NSTE-ACS) is due to the "risk-treatment" paradox (RTP). However, the true prevalence, types and causes of RTP have not been studied, and data from previous studies have shown an equivocal effect of RTP on outcomes of NSTE-ACS.
methodsThe retrospective analysis included 600 patients initially diagnosed with NSTE-ACS. Upon admission, all patients were re-stratified into four groups according to their risk of adverse ischemic events. RTP was defined as a mismatch between a patient's risk profile and the recommended invasive strategy.
resultsRTP was present in 53.5% of the study population (321/600), with the highest frequency observed in the intermediate-risk group (74%) and the lowest in the high-risk group (28.5%). In the overall cohort, the presence of RTP (n = 321) was not associated with a significant difference in in-hospital adverse cardiovascular events or length of stay compared to patients without RTP (n = 279). After adjustment for RTP in each risk group, only the high-risk group showed an increase in adverse outcomes in the presence of RTP (5.4% mortality vs. 2.9% (OR 1.9 (95% CI 0.5-8.9), p = 0.037) and a negative effect of RTP on the risk of recurrent myocardial ischemia (RMI) after 24 h (7.1% vs. 0.7%, OR 10.7 (95% CI 1.2-97.9), p = 0.01).
conclusionsRTP in relation to the type of invasive strategy is common in patients with NSTE-ACS (53.5%). For high-risk patients, RTP worsened in-hospital outcome and influenced the risk of RMI after 24 h. CLINICAL TRIAL NUMBER: This research is a retrospective observational study, which does not require mandatory registration as defined by the ICMJE.
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