Time to coronary angiography in patients with non-ST-segment elevation acute coronary syndrome: how fast should patients go to the catheterization laboratory?
OBJECTIVE
This review describes available data on the optimal timing of an early invasive strategy in patients with high-risk non-ST-segment elevation acute coronary syndromes, along with challenges with type of studies. We also discuss the implication of timing in the overall management of the non-ST-segment elevation acute coronary syndrome patients.


RESULTS
The issue of timing of the coronary angiography has been addressed mainly with observational analyses. The only, small, randomized clinical trial, the Intracoronary Stenting With Antithrombotic Regimen Cooling-Off, indicated a superiority of an expedited approach compared with a much deferred angiography. A recent observational analysis adopting special statistical methodologies confirmed the finding of the Intracoronary Stenting With Antithrombotic Regimen Cooling-Off trial in patients undergoing an early invasive strategy in the first 48 h of presentation.


CONCLUSIONS
Current evidence is not sufficient to recommend the use of a routine expedite invasive strategy but suggests that it may be a viable approach.
Tricoci
Pierluigi
P
Division of Cardiology, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina 27705, USA. trico001@dcri.duke.edu
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D006328:Cardiac Catheterization; D017023:Coronary Angiography / Q000379:methods*; D004562:Electrocardiography; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
D005343:Fibrinolytic Agents