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首页> 外文OA文献 >Timing of Angiography With a Routine Invasive Strategy and Long-Term Outcomes in Non-ST-Segment Elevation Acute Coronary Syndrome A Collaborative Analysis of Individual Patient Data From the FRISC II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) Trials
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Timing of Angiography With a Routine Invasive Strategy and Long-Term Outcomes in Non-ST-Segment Elevation Acute Coronary Syndrome A Collaborative Analysis of Individual Patient Data From the FRISC II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) Trials

机译：非ST段抬高急性冠脉综合征的常规血管造影术时机和长期结果的时机分析：来自FRISC II（冠状动脉疾病不稳定期间的Fragmin和快速血运重建），ICTUS（有创）的个别患者数据的协作分析不稳定型冠状动脉综合征的保守治疗和保守治疗，以及不稳定型心绞痛或非ST段抬高型心肌梗死患者的干预性保守治疗策略

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Objectives This study sought to investigate long-term outcomes after early or delayed angiography in patients with non-ST-segment elevation acute coronary syndrome (nSTE-ACS) undergoing a routine invasive management. Background The optimal timing of angiography in patients with nSTE-ACS is currently a topic for debate. Methods Long-term follow-up after early (within 2 days) angiography versus delayed (within 3 to 5 days) angiography was investigated in the FRISC-II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) (FIR) nSTE-ACS patient-pooled database. The main outcome was cardiovascular death or myocardial infarction up to 5-year follow-up. Hazard ratios (HR) were calculated with Cox regression models. Adjustments were made for the FIR risk score, study, and the propensity of receiving early angiography using inverse probability weighting. Results Of 2,721 patients originally randomized to the routine invasive arm, consisting of routine angiography and subsequent revascularization if suitable, 975 underwent early angiography and 1,141 delayed angiography. No difference was observed in 5-year cardiovascular death or myocardial infarction in unadjusted (HR: 1.06, 95% confidence interval [CI]: 0.79 to 1.42, p = 0.61) and adjusted (HR: 0.93, 95% CI: 0.75 to 1.16, p = 0.54) Cox regression models. Conclusions In the FIR database of patients presenting with nSTE-ACS, the timing of angiography was not related to long-term cardiovascular mortality or myocardial infarction. (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes [ICTUS]; ISRCTN82153174. Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction [the Third Randomised Intervention Treatment of Angina Trials (RITA-3)]; ISRCTN07752711) (J Am Coll Cardiol Intv 2012;5:191-9) (C) 2012 by the American College of Cardiology Foundation
机译：目的本研究旨在探讨接受常规侵入性治疗的非ST段抬高急性冠状动脉综合征（nSTE-ACS）患者在早期或延迟血管造影后的长期预后。背景技术目前，nSTE-ACS患者的血管造影最佳时机是一个有争议的话题。方法在FRISC-II（冠状动脉疾病不稳定期间的Fragmin和快速血运重建），ICTUS（侵入性对比保守）中研究了早期（2天之内）血管造影与延迟（3至5天之内）血管造影的长期随访情况。不稳定型冠状动脉综合征的治疗）和RITA-3（不稳定型心绞痛或非ST段抬高型心肌梗死患者的干预与保守治疗策略）（FIR）nSTE-ACS患者合并数据库。主要结果是长达5年随访的心血管死亡或心肌梗塞。使用Cox回归模型计算危险比（HR）。使用逆概率加权对FIR风险评分，研究和接受早期血管造影的倾向进行了调整。结果2 721例患者最初被随机分配到常规侵入性血管造影，包括常规血管造影和随后的血管重建术，其中975例接受了早期血管造影，而1 141例延迟了血管造影。未经调整（HR：1.06，95％置信区间[CI]：0.79至1.42，p = 0.61）和经过调整（HR：0.93，95％CI：0.75至1.16）的5年心血管疾病死亡或心肌梗死无差异，p = 0.54）Cox回归模型。结论在nSTE-ACS患者的FIR数据库中，血管造影的时机与长期心血管死亡率或心肌梗塞无关。 （不稳定型冠状动脉综合征的侵入性与保守治疗[ICTUS]； ISRCTN82153174。不稳定型心绞痛或非ST段抬高型心肌梗死的患者的干预与保守治疗策略[心绞痛试验的第三次随机干预治疗（RITA-3）]； ISRCTN07752711） （J Am Coll Cardiol Intv 2012; 5：191-9）（C）2012年美国心脏病学会基金会

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