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Impact of percutaneous coronary intervention timing on 5-year outcome in patients with non-ST-segment elevation acute coronary syndromes. The ‘wait a day’ approach might be safer
BACKGROUND: The OPTIMA trial was a randomised multicentre trial exploring the influence of the timing of percutaneous coronary intervention (PCI) on patient outcomes in an intermediate to high risk non-ST-elevation acute coronary syndrome (NSTE-ACS) population. In order to decide the best treatment...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bohn Stafleu van Loghum
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771630/ https://www.ncbi.nlm.nih.gov/pubmed/26860709 http://dx.doi.org/10.1007/s12471-016-0803-0 |
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author | Oosterwerff, Erik F.J. Fagel, N. D. Slagboom, T. Tijssen, J. G. P. Herrman, J. P. Smits, P. C. Suttorp, M. J. Ronner, E. Laarman, G. J. Patterson, M. S. Amoroso, G. Vink, M. A. van der Schaaf, R. J. Verheugt, F. W. A. Riezebos, R. K. |
author_facet | Oosterwerff, Erik F.J. Fagel, N. D. Slagboom, T. Tijssen, J. G. P. Herrman, J. P. Smits, P. C. Suttorp, M. J. Ronner, E. Laarman, G. J. Patterson, M. S. Amoroso, G. Vink, M. A. van der Schaaf, R. J. Verheugt, F. W. A. Riezebos, R. K. |
author_sort | Oosterwerff, Erik F.J. |
collection | PubMed |
description | BACKGROUND: The OPTIMA trial was a randomised multicentre trial exploring the influence of the timing of percutaneous coronary intervention (PCI) on patient outcomes in an intermediate to high risk non-ST-elevation acute coronary syndrome (NSTE-ACS) population. In order to decide the best treatment strategy for patients presenting with NSTE-ACS, long-term outcomes are essential. METHODS: Five-year follow-up data from 133 of the 142 patients could be retrieved (94 %). The primary endpoint was a composite of death and spontaneous myocardial infarction (MI). Spontaneous MI was defined as MI occurring more than 30 days after randomisation. Secondary endpoints were the individual outcomes of death, spontaneous MI or re-PCI. RESULTS: No significant difference with respect to the primary endpoint was observed (17.8 vs. 10.1 %; HR 1.55, 95 % CI: 0.73–4.22, p = 0.21). There was no significant difference in mortality rate. However, spontaneous MI was significantly more common in the group receiving immediate PCI (11.0 vs. 1.4 %; HR 4.46, 95 % CI: 1.21–16.50, p = 0.02). We did not find a significant difference between the groups with respect to re-PCI rate. CONCLUSION: There was no difference in the composite of death and spontaneous MI. The trial suggests an increased long-term risk of spontaneous MI for patients treated with immediate PCI. |
format | Online Article Text |
id | pubmed-4771630 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-47716302016-03-22 Impact of percutaneous coronary intervention timing on 5-year outcome in patients with non-ST-segment elevation acute coronary syndromes. The ‘wait a day’ approach might be safer Oosterwerff, Erik F.J. Fagel, N. D. Slagboom, T. Tijssen, J. G. P. Herrman, J. P. Smits, P. C. Suttorp, M. J. Ronner, E. Laarman, G. J. Patterson, M. S. Amoroso, G. Vink, M. A. van der Schaaf, R. J. Verheugt, F. W. A. Riezebos, R. K. Neth Heart J Original Article - E-learning Article BACKGROUND: The OPTIMA trial was a randomised multicentre trial exploring the influence of the timing of percutaneous coronary intervention (PCI) on patient outcomes in an intermediate to high risk non-ST-elevation acute coronary syndrome (NSTE-ACS) population. In order to decide the best treatment strategy for patients presenting with NSTE-ACS, long-term outcomes are essential. METHODS: Five-year follow-up data from 133 of the 142 patients could be retrieved (94 %). The primary endpoint was a composite of death and spontaneous myocardial infarction (MI). Spontaneous MI was defined as MI occurring more than 30 days after randomisation. Secondary endpoints were the individual outcomes of death, spontaneous MI or re-PCI. RESULTS: No significant difference with respect to the primary endpoint was observed (17.8 vs. 10.1 %; HR 1.55, 95 % CI: 0.73–4.22, p = 0.21). There was no significant difference in mortality rate. However, spontaneous MI was significantly more common in the group receiving immediate PCI (11.0 vs. 1.4 %; HR 4.46, 95 % CI: 1.21–16.50, p = 0.02). We did not find a significant difference between the groups with respect to re-PCI rate. CONCLUSION: There was no difference in the composite of death and spontaneous MI. The trial suggests an increased long-term risk of spontaneous MI for patients treated with immediate PCI. Bohn Stafleu van Loghum 2016-02-09 2016-03 /pmc/articles/PMC4771630/ /pubmed/26860709 http://dx.doi.org/10.1007/s12471-016-0803-0 Text en © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article - E-learning Article Oosterwerff, Erik F.J. Fagel, N. D. Slagboom, T. Tijssen, J. G. P. Herrman, J. P. Smits, P. C. Suttorp, M. J. Ronner, E. Laarman, G. J. Patterson, M. S. Amoroso, G. Vink, M. A. van der Schaaf, R. J. Verheugt, F. W. A. Riezebos, R. K. Impact of percutaneous coronary intervention timing on 5-year outcome in patients with non-ST-segment elevation acute coronary syndromes. The ‘wait a day’ approach might be safer |
title | Impact of percutaneous coronary intervention timing on 5-year outcome in patients with non-ST-segment elevation acute coronary syndromes. The ‘wait a day’ approach might be safer |
title_full | Impact of percutaneous coronary intervention timing on 5-year outcome in patients with non-ST-segment elevation acute coronary syndromes. The ‘wait a day’ approach might be safer |
title_fullStr | Impact of percutaneous coronary intervention timing on 5-year outcome in patients with non-ST-segment elevation acute coronary syndromes. The ‘wait a day’ approach might be safer |
title_full_unstemmed | Impact of percutaneous coronary intervention timing on 5-year outcome in patients with non-ST-segment elevation acute coronary syndromes. The ‘wait a day’ approach might be safer |
title_short | Impact of percutaneous coronary intervention timing on 5-year outcome in patients with non-ST-segment elevation acute coronary syndromes. The ‘wait a day’ approach might be safer |
title_sort | impact of percutaneous coronary intervention timing on 5-year outcome in patients with non-st-segment elevation acute coronary syndromes. the ‘wait a day’ approach might be safer |
topic | Original Article - E-learning Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771630/ https://www.ncbi.nlm.nih.gov/pubmed/26860709 http://dx.doi.org/10.1007/s12471-016-0803-0 |
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