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Ischemia-Guided Approach Versus Early Invasive Approach for NSTE-ACS: How Early Is Early?

  • Management of Acute Coronary Syndromes (H Jneid, Section Editor)
  • Published:
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Abstract

Purpose of Review

Non-ST segment elevation acute coronary syndromes (NSTE-ACS) account for 70% of the patients with ACS. Most NSTE-ACS patients receive invasive therapies. Despite improvements in the systems of care and interventional techniques, the mortality of NSTE-ACS patients remains high, and delays in the treatment of NSTE-ACS patients continue to be a problem. This paper aims to discuss the importance of timeliness of invasive strategy in the treatment of NSTE-ACS as well as the state-of-the-art approach to this critical health problem.

Recent Findings

The relatively recent guidelines and meta-analyses on the subject try to shed light on the issue of timing. The picture is now a little clearer, but still much remains to be answered.

Summary

We know that the early invasive strategy at least is safe and improves recurrent ischemia and refractory angina as well as the length of stay, lowering the cost. In higher-risk patients, there is a benefit for a more aggressive approach. The definition of “early” in the early invasive strategy has evolved over the past decade and currently pertains to an invasive strategy performed within 12–24 h of presentation.

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Authors and Affiliations

  1. Baylor College of Medicine, Houston, TX, USA

    Ali E. Denktas

  2. MEDVAMC, 2002 Holcombe Blvd., Mail Code 111B Cardiology, Houston, TX, 77030, USA

    Ali E. Denktas

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Ali E. Denktas declares that he has no conflict of interest.

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This article is part of the Topical Collection on Management of Acute Coronary Syndromes

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Denktas, A.E. Ischemia-Guided Approach Versus Early Invasive Approach for NSTE-ACS: How Early Is Early?. Curr Cardiol Rep 23, 34 (2021). https://doi.org/10.1007/s11886-021-01462-x

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  • DOI: https://doi.org/10.1007/s11886-021-01462-x

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