Long-term outcomes based on time-to-angiography in patients admitted with non-ST-segment elevation acute coronary syndromes

Mouaz Al-Mallah, Khaled Dajani, Michael Hudson, Hrishikesh Iyengar, Noel Gutierrez, W. Douglas Weaver, Sanjaya Khanal

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective. We investigated the impact of the duration from hospital admission to coronary angiography on the outcome of patients admitted with non ST-segment elevation acute coronary syndromes (NSTE-ACS). Background. Invasive risk stratification in patients with acute coronary syndromes (ACS) has been shown to improve outcome in contemporary studies. It is unclear whether early coronary angiography is better than initial medical therapy with later angiography. Methods. We performed an analysis of patients admitted to a tertiary coronary intensive care unit (CICU) with NSTE-ACS and had coronary angiography performed during the same hospitalization. Patients were categorized into three groups based on the time-to-angiography: same-day, 1 to 2 days, and > 2 days. The baseline clinical features, angiography results, 30-day, 6-month cardiovascular outcome and 3-year mortality rate were compared between the groups before and after adjusting for confounding variables. Results. A total of 836 fulfilled the inclusion criteria. Patients undergoing angiography > 2 days had a higher incidence of 3-vessel disease (45.7% vs. 31.7%, p < 0.001), underwent less percutaneous interventions at the time of the angiography (41.6% vs. 56.7%, p < 0.001), and more frequent coronary artery bypass surgery (9.9% vs. 15.3%, p = 0.05). Patients undergoing late invasive risk stratification (> 2 days) had increased 3-year mortality (OR 2.12, 95% CI 1.03-4.35, p = 0.04) after adjusting for confounding variables. Conclusion. In patients with NSTE-ACS and no contraindication to angiography, delayed angiography of more than 2 days of presentation was associated with increased mortality at 3 years.

Original languageEnglish (US)
Pages (from-to)251-255
Number of pages5
JournalJournal of Invasive Cardiology
Volume17
Issue number5
StatePublished - May 1 2005

Keywords

  • Acute coronary syndrome
  • Coronary angiography
  • Outcome

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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