Skip to main content
main-content
Top

Tip

Swipe om te navigeren naar een ander artikel

09-02-2016 | Original Article - E-learning Article | Uitgave 3/2016 Open Access

Netherlands Heart Journal 3/2016

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

Tijdschrift:
Netherlands Heart Journal > Uitgave 3/2016
Auteurs:
Erik F.J. Oosterwerff, N. D. Fagel, T. Slagboom, J. G. P. Tijssen, J. P. Herrman, P. C. Smits, M. J. Suttorp, E. Ronner, G. J. Laarman, M. S. Patterson, G. Amoroso, M. A. Vink, R. J. van der Schaaf, F. W. A. Verheugt, R. K. Riezebos

Abstract

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.

Onze productaanbevelingen

Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Literatuur
Over dit artikel

Andere artikelen Uitgave 3/2016

Netherlands Heart Journal 3/2016 Naar de uitgave

Rhythm Puzzle - Answer

The mystery of the fourth beat