• I Llaó, J A Gómez-Hospital, J Aboal, C Garcia, S Montero, A Sambola, J Ortiz, C Tomás, G Bonet, D Viñas, T Oliveras, J Sans-Roselló, J Cantalapiedra, R Andrea, I Hernández, M Pérez-Rodriguez, M Gual, A Cequier, A Ariza-Solé, and en representación de los investigadores del Grup de Treball de Cures Agudes Cardiològiques de la Societat Catalana de Cardiologia.
• Unidad de Cuidados Intensivos Cardiológicos, Servicio de Cardiología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España.
• Med Intensiva. 2020 Nov 1; 44 (8): 475-484.

ObjectiveCurrent guidelines recommend a risk-adjusted early invasive strategy (EIS) in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). The present study assesses the application if this strategy, the conditioning factors and prognostic impact upon patients with NSTEACS admitted to Intensive Cardiac Care Units (ICCU).DesignA prospective cohort study was carried out.SettingThe ICCUs of 8 hospitals in Catalonia (Spain).PatientsConsecutive patients with NSTEACS between October 2017 and March 2018. The risk profile was defined by the European Society of Cardiology criteria.InterventionsEIS was defined as the performance of coronary angiography within the first 6hours in patients at very high-risk or within 24hours in high-risk patients.Outcome VariablesMortality or readmission at 6 months.ResultsA total of 629 patients were included (mean age 66.6 years), of whom 225 (35.9%) were at very high risk, and 392 (62.6%) at high risk. Most patients (96.2%) underwent an invasive strategy. EIS was performed in 284 patients (45.6%), especially younger patients with fewer comorbidities. These patients had a shorter ICCU and hospital stay, as well as a lesser incidence of ACS, revascularization and death or readmission at 6 months. After adjusting for confounders, the association between EIS and death or readmission at 6 months remained significant (hazard ratio: .66, 95% confidence interval .45-.97; P=.035).ConclusionsThe EIS was performed in a minority of NSTEACS admitted to ICCU, being associated with better outcomes.Copyright © 2019 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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