Author + information
- Abel Casso Dominguez,
- Alejandro Lemor,
- Shawn Lee,
- Yasmin I. Herrera,
- Daniel Leal and
- Georges El-Hayek
Background: The accepted strategy for the management of Non-ST Segment Elevation Myocardial Infarction (NSTEMI) includes an invasive approach, however the optimal timing of this strategy remains less well defined than for ST-segment elevation myocardial infarction
Methods: This is a retrospective cohort study of adult patients hospitalized in 2013 with NSTEMI in acute-care hospitals across the United States. Patients were selected from the Nationwide Inpatient Sample (NIS) database. The patients were classified in two groups, an early-intervention group (invasive intervention within 24 h of hospitalization) and a delayed-intervention group (invasive intervention >24 h of hospitalization). The primary outcome was in-hospital mortality. Secondary outcomes included shock, acute kidney injury (AKI), acute respiratory failure (ARF), admission to intensive care unit (ICU), and length of stay (LOS). The results were adjusted for age, gender, race, and Charlson comorbidity index.
Results: The study included 422,795 patients with NSTEMI. Baseline patient characteristics are included in Table 1. The rate of adjusted in-hospital mortality was reduced in the early versus delayed group (Table 2). There was also a reduction in the occurrence of shock, AKI, ARF, admission to the ICU, and LOS.
Conclusions: This study suggest benefits of an early invasive intervention in patients with NSTEMI, with reductions of death, shock, AKI, ARF, ICU level of care, and LOS.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-319
- 2017 American College of Cardiology Foundation