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Díez-Delhoyo F, López Lluva MT, Cepas-Guillén P, Jurado-Román A, Bazal-Chacón P, Negreira-Caamaño M, Olavarri-Miguel I, Elorriaga A, Fernández-Sánchez JA, Escribano D, Salinas P, Vaquero-Luna J, Prieto-Lobato A, Pérez-Cebey L, Carrasquer A, Llaóo I, Torres Mezcúa FJ, Giralt-Borrell T, Abellas M, García-Blas S, Matute-Blanco L, Robles-Gamboa C, Martínez-Guisado A, Fernández-Cordón C, González-Maniega C, Díez-Villanueva P. Timing of coronary angiography and use of antiplatelet pretreatment in patients with NSTEACS in Spain. Rev Esp Cardiol (Engl Ed) 2024; 77:234-242. [PMID: 38476000 DOI: 10.1016/j.rec.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/27/2023] [Indexed: 03/14/2024]
Abstract
INTRODUCTION AND OBJECTIVES The optimal timing of coronary angiography in patients admitted with non-ST-segment elevation acute coronary syndrome (NSTEACS) as well as the need for pretreatment are controversial. The main objective of the IMPACT-TIMING-GO registry was to assess the proportion of patients undergoing an early invasive strategy (0-24hours) without dual antiplatelet therapy (no pretreatment strategy) in Spain. METHODS This observational, prospective, and multicenter study included consecutive patients with NSTEACS who underwent coronary angiography that identified a culprit lesion. RESULTS Between April and May 2022, we included 1021 patients diagnosed with NSTEACS, with a mean age of 67±12 years (23.6% women). A total of 87% of the patients were deemed at high risk (elevated troponin; electrocardiogram changes; GRACE score>140) but only 37.8% underwent an early invasive strategy, and 30.3% did not receive pretreatment. Overall, 13.6% of the patients underwent an early invasive strategy without pretreatment, while the most frequent strategy was a deferred angiography under antiplatelet pretreatment (46%). During admission, 9 patients (0.9%) died, while major bleeding occurred in 34 (3.3%). CONCLUSIONS In Spain, only 13.6% of patients with NSTEACS undergoing coronary angiography received an early invasive strategy without pretreatment. The incidence of cardiovascular and severe bleeding events during admission was low.
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Affiliation(s)
| | | | | | | | - Pablo Bazal-Chacón
- Servicio de Cardiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Iván Olavarri-Miguel
- Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Ane Elorriaga
- Servicio de Cardiología, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain
| | | | - David Escribano
- Servicio de Cardiología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, Spain
| | - Pablo Salinas
- Servicio de Cardiología, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | | | - Lucía Pérez-Cebey
- Servicio de Cardiología, Hospital Universitario de A Coruña, A Coruña, Spain
| | - Anna Carrasquer
- Servicio de Cardiología, Hospital Joan XXIII, Tarragona, Spain
| | - Isaac Llaóo
- Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - María Abellas
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Sergio García-Blas
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
| | - Lucía Matute-Blanco
- Servicio de Cardiología, Hospital Universitario Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
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