Myocardial Infarction Clinical Trial
Official title:
Randomized Study of ImmeDiate Versus DeLayEd Invasive Intervention in Patients With Non ST-segment Elevation Myocardial Infarction
In patients with acute myocardial infarction without ST-segment elevation on ECG (non-STEMI),
previous studies have indicated that routine invasive treatment confers more benefit as
compared to selective invasive approach. The benefits of routine invasive coronary
intervention have been the most evident in patients with higher baseline risk profile.
However, the question of optimal timing of routine invasive intervention remains unsolved.
Immediate invasive intervention early after admission for non-STEMI may limit myocardial
necrosis by securing the patency of the culprit coronary artery. Nevertheless, several
previous studies reported higher levels of biomarkers of myocardial injury in patients
undergoing early PCI. The question of earlier versus delayed procedure in non-STEMI patients
may thus amount to whether the risk of intervening on an unstable plaque is greater than the
risk of new ischemic events while waiting for the invasive procedure.
The purpose of the present study is to compare effects of immediate coronary intervention,
within 2 hours of admission, versus delayed intervention, within 2-72 hours after admission,
in patients witn non-STEMI.
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