[Elective coronary angioplasty in acute coronary syndromes: early versus delayed treatment].
BACKGROUND
In patients with acute coronary syndromes (ACS) the optimal time required to stabilize the patient before attempting coronary intervention (PTCA) is uncertain. The recent use of newer devices and antiplatelet drugs allowed earlier percutaneous intervention.


OBJECTIVE
We examined the efficacy and safety of coronary angioplasty in patients with ACS according to the period of stabilization with medical therapy.


METHODS
We included 83 patients, 15 female, 54 with unstable angina and 29 with non-ST elevation myocardial infarction. We studied the rate of complications related to the procedure, the duration of CCU and hospital stay according to the period of stabilization with medical therapy: < 48 hours (early PTCA) and > or = 48 hours (delayed PTCA).


RESULTS
No significant differences were found between the two groups of patients with respect to success rate (92% in early PTCA vs 98% in delayed PTCA), stents implantation (74% vs 78%), use of abeiximab (42% vs 24%), abrupt closure during procedure (3% vs 2%), infarct related procedure (0% vs 7%), re-PTCA (5% vs 7%) and surgical revascularization (0% vs 2%). No deaths occurred, CCU stay (2.5 vs 6.7 days, p < 0.001) and hospital stay (4 vs 9.4 days, p = 0.001) were significantly shorter in the group of early PTCA.


CONCLUSIONS
In the present group of patients with ACS, early coronary intervention was a safe procedure with a shorter CCU and hospital stay compared with deferred PTCA.
Almeida
M
M
Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide.
Ferreira
J
J
Real
T
T
Machado
F
F
Baptista
J
J
Palos
J
J
Silva
A
A
Seabra-Gomes
R
R
D000077284:Abciximab; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000601:surgery; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D003327:Coronary Disease / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D013997:Time Factors
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D000077284:Abciximab