Effect of an early invasive strategy based on time of symptom onset in patients with non-ST elevation myocardial infarction

Abstract Background A limitation of the current guidelines timing invasive coronary angiography (ICA) for patients with non-ST-segment elevation (NSTE) acute syndrome is based on randomization time. So far, no study has reported clinical outcomes strategy time symptom onset. Herein, we aimed to investigate effect from onset 3-year NSTE myocardial infarction (MI). Methods and results Among 13,104 Korea Acute Myocardial Infarction Registry-National Institutes Health, evaluated 5,856 NSTEMI. The were categorized according symptom-to-catheter (StC) (<48 h ≥48 h). primary outcome was all-cause mortality, secondary a composite recurrent MI, hospitalization heart failure. Overall, 3,919 (66.9%) classified into StC <48 group. This group had lower mortality than (7.3% vs. 13.4%, p<0.001). continuous association risk endpoints showed shorter (reference: 48 h), adjusted hazard ratio reduction observed. In multivariable analysis, independent predictors delayed ICA older age, non-specific symptoms, use emergency medical services, ST-segment deviation, chronic kidney disease, Global Registry Coronary Events score >140. Conclusion Early improves in Funding Acknowledgement Type funding sources: None.