Early versus delayed invasive strategy in patients with non-ST-elevation acute coronary syndrome and concomitant congestive heart failure

• Published in: Journal of cardiology 2019-10, Vol.74 (4), p.320-327
• Main Authors: Yoshida, Ruka, Ishii, Hideki, Morishima, Itsuro, Tanaka, Akihito, Morita, Yasuhiro, Takagi, Kensuke, Yoshioka, Naoki, Hirayama, Kenshi, Iwakawa, Naoki, Tashiro, Hiroshi, Kojima, Hiroki, Mitsuda, Takayuki, Hitora, Yusuke, Furusawa, Kenji, Tsuboi, Hideyuki, Murohara, Toyoaki
• Format: Article
• Language: English
• Subjects: Congestive heart failure; Coronary artery bypass grafting; Non-ST-elevation acute coronary syndrome; Percutaneous coronary intervention
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2019.03.006

•Early intervention for non-ST elevation acute coronary syndrome (NSTE-ACS) with congestive heart failure (CHF) significantly prevented adverse cardiac events.•The benefit of early intervention was mainly observed in patients needing ventilators.•The risk of bleeding and acute kidney injury were higher in the early invasive group.•Most NSTE-ACS patients with CHF revealed advanced coronary artery disease. Although there are guidelines that recommend an early invasive strategy in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and concomitant congestive heart failure (CHF), optimal timing of the invasive strategy remains controversial. Among 2045 patients who were admitted owing to NSTE-ACS or CHF, 300 presented with NSTE-ACS and concomitant CHF. Of the 300 patients, we enrolled 160 patients for whom coronary angiography (CAG) during their hospital stay was planned at the time of admission; 64 of these patients were classified into the early invasive group (