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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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bohn Stafleu van Loghum 2016
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.
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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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