Featured Research

from universities, journals, and other organizations

Immediate Intervention For Patients With Acute Coronary Syndromes Not Always More Beneficial

Date:
September 15, 2009
Source:
JAMA and Archives Journals
Summary:
For some patients with acute coronary syndromes, the strategy of immediate intervention at a medical center does not appear to result in differences in outcomes in comparison with an intervention performed the next working day, according to a new study.

For some patients with acute coronary syndromes, the strategy of immediate intervention at a medical center does not appear to result in differences in outcomes in comparison with an intervention performed the next working day, according to a study in the September 2 issue of JAMA.

"The optimal intervention in the treatment strategy of patients presenting with acute coronary syndromes without ST-segment elevation (NSTE-ACS) has been debated for years," the authors write in background information for the study. "Numerous studies, randomized trials, and meta-analyses have investigated the potential benefits of invasive over conservative strategies, and most have suggested a prolonged advantage of an invasive approach for the prevention of death of myocardial infarction [MI; heart attack], particularly among high-risk patients."

Gilles Montalescot, M.D., Ph.D., of the Institut de Cardiologie, Centre Hospitalier Universitaire Pitie-Sapetriere, Paris, and colleagues from The Angioplasty to Blunt the Rise of Troponin in Acute Coronary Syndromes Randomized for an Immediate or Delayed Intervention (ABOARD) study evaluated data from 352 patients with acute coronary syndromes at 13 high-volume medical centers in France with 24-hour facilities for treatment of primary percutaneous coronary intervention (e.g, balloon angioplasty or stent placement) from August 2006 through September 2008. The patients, all of whom had acute coronary syndromes without ST-segment elevation (a certain pattern on the electrocardiogram [ECG]), were randomized to undergo an immediate invasive strategy or an invasive strategy scheduled on the next working day. The primary end point was the peak troponin value (biomarker indicating heart muscle involvement or damage) during hospitalization. The key secondary end point was the composite of death, myocardial infarction, or urgent revascularization at one-month follow-up.

"Time from randomization to sheath insertion [beginning of the catheterization procedure] was 70 minutes with immediate intervention vs. 21 hours with delayed intervention," the authors report. "Troponin I release, as reflected by peak value collected during hospitalization, did not differ between the two strategies in the immediate and delayed intervention groups. The probability of MI as measured by the curves of troponin peak values was similar with either strategy." The authors also found that "the key secondary end point was observed in 13.7 percent of the group assigned to receive immediate intervention and 10.2 percent of the group assigned to receive delayed intervention. The other end points, as well as major bleeding, did not differ between the two strategies." The authors note that hospital stay was significantly reduced with the immediate strategy compared with the delayed intervention strategy.

"This study demonstrates the feasibility of immediate catheterization and revascularization in patients who present with NTSE-ACS but does not show that this strategy is superior to catheterization scheduled on the next working day," the authors write. "Thus, rapid or urgent catheterization appears preferable in high-risk or unstable patients, while the benefit in other situations may be limited to practicality and length of hospital stay," the authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Gilles Montalescot; Guillaume Cayla; Jean-Philippe Collet; Simon Elhadad; Farzin Beygui; Herve Le Breton; Remi Choussat; Florence Leclercq; Johanne Silvain; Francois Duclos; Mounir Aout; Jean-Luc Dubois-Rande; Olivier Barthelemy; Gregory Ducrocq; Anne Bellemain-Appaix; Laurent Payot; Philippe-Gabriel Steg; Patrick Henry; Christian Spaulding; Eric Vicaut; for the ABOARD Investigators. Immediate vs Delayed Intervention for Acute Coronary Syndromes: A Randomized Clinical Trial. JAMA, 2009; 302 (9): 947-954 [link]

Cite This Page:

JAMA and Archives Journals. "Immediate Intervention For Patients With Acute Coronary Syndromes Not Always More Beneficial." ScienceDaily. ScienceDaily, 15 September 2009. <www.sciencedaily.com/releases/2009/09/090901163914.htm>.
JAMA and Archives Journals. (2009, September 15). Immediate Intervention For Patients With Acute Coronary Syndromes Not Always More Beneficial. ScienceDaily. Retrieved July 29, 2014 from www.sciencedaily.com/releases/2009/09/090901163914.htm
JAMA and Archives Journals. "Immediate Intervention For Patients With Acute Coronary Syndromes Not Always More Beneficial." ScienceDaily. www.sciencedaily.com/releases/2009/09/090901163914.htm (accessed July 29, 2014).

Share This




More Health & Medicine News

Tuesday, July 29, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Deadly Ebola Virus Threatens West Africa

Deadly Ebola Virus Threatens West Africa

AP (July 28, 2014) West African nations and international health organizations are working to contain the largest Ebola outbreak in history. It's one of the deadliest diseases known to man, but the CDC says it's unlikely to spread in the U.S. (July 28) Video provided by AP
Powered by NewsLook.com
$15B Deal on Vets' Health Care Reached

$15B Deal on Vets' Health Care Reached

AP (July 28, 2014) A bipartisan deal to improve veterans health care would authorize at least $15 billion in emergency spending to fix a veterans program scandalized by long patient wait times and falsified records. (July 28) Video provided by AP
Powered by NewsLook.com
Two Americans Contract Ebola in Liberia

Two Americans Contract Ebola in Liberia

Reuters - US Online Video (July 28, 2014) Two American aid workers in Liberia test positive for Ebola while working to combat the deadliest outbreak of the virus ever. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Traditional African Dishes Teach Healthy Eating

Traditional African Dishes Teach Healthy Eating

AP (July 28, 2014) Classes are being offered nationwide to encourage African Americans to learn about cooking fresh foods based on traditional African cuisine. The program is trying to combat obesity, heart disease and other ailments often linked to diet. (July 28) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins