Assessment of Outcomes and Treatment Tactics in Patients With Non-ST-Elevation Acute Coronary Syndrome: Data of Five-Year Follow-up

Objective: This study aimed to evaluate the clinical significance and safety of optical coherence tomography (OCT) in patients with non-ST-elevation acute coronary syndrome (NSTEACS) combined with intermediate lesions.Methods: Sixty-five NSTEACS patients with intermediate lesions confirmed with coronary angiography at our department were included in this study. Among them, 33 patients received only standardized drug treatment (drug group) and the other 32 patients received percutaneous coronary intervention (PCI) according to the OCT examination based on drug treatment (OCT group). Major adverse cardiovascular events (MACEs), revascularization, success rate of OCT examination, related complications, and other patient situations in the two groups during hospitalization and the 12-month follow-up period were compared.Results: No death or stroke occurred in either group during hospitalization and follow-up. In the drug treatment group, six patients experienced frequent angina, and five patients with acute myocardial infarction were rehospitalized and underwent PCI procedures. In the OCT group, although two patients underwent repeat revascularization, no additional acute myocardial infarction events occurred. There was a statistically significant difference between the two groups (P < .01). All patients in the OCT group successfully completed the related vessel examination, and 24 patients underwent PCI procedures because of unstable plaque diagnosed with OCT.Conclusion: OCT-guided PCI is safe and effective for the treatment of patients with NSTEACS combined with intermediate lesions.

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5-year outcomes in the FRISC-II randomised trial of an invasive versus a non-invasive strategy in non-ST-elevation acute coronary syndrome: a follow-up study

The Lancet ◽

10.1016/s0140-6736(06)69416-6 ◽

2006 ◽

Vol 368 (9540) ◽

pp. 998-1004 ◽

Cited By ~ 177

Author(s):

Bo Lagerqvist ◽

Steen Husted ◽

Fredrik Kontny ◽

Elisabeth Ståhle ◽

Eva Swahn ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Randomised Trial ◽

Invasive Strategy ◽

Coronary Syndrome ◽

Non Invasive ◽

Follow Up Study ◽

St Elevation ◽

Elevation Acute Coronary Syndrome

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The Bleeding Safety of Ticagrelor in Patients With ST-Elevation Acute Coronary Syndrome Treated With Fibrinolytic Therapy

Kardiologiia ◽

10.18087/cardio.2020.6.n867 ◽

2020 ◽

Vol 60 (6) ◽

pp. 92-95

Author(s):

A. V. Bocharov ◽

D. V. Sidorov

Keyword(s):

Acute Coronary Syndrome ◽

Treatment Group ◽

Fibrinolytic Therapy ◽

Intracranial Hemorrhages ◽

St Segment Elevation ◽

Coronary Syndrome ◽

St Segment ◽

St Elevation ◽

Elevation Acute Coronary Syndrome

Aim To compare hemorrhagic safety of ticagrelor and clopidogrel in patients with ST-segment elevation acute coronary syndrome (STEACS) after thrombolytic therapy (TLT).Material and methods This nonrandomized study included 183 patients followed up for 30 days. Hemorrhagic safety was compared in a group of patients with STEACS (n=71) after a thrombolytic treatment with alteplase and early ticagrelor treatment (180 mg followed by switching to 90 mg twice daily) and in a group of patients (n=112) with STEACS receiving TLT with alteplase and clopidogrel (loading dose, 600 mg followed by switching to 75 mg daily). Primary endpoint was hemorrhage associated with TLT; patients were followed up for 30 days.Results During the follow-up period, TLT-associated hemorrhages were observed in 11.3% of patients in the ticagrelor treatment group and in 10.7% of patients in the clopidogrel treatment group (p=0.9; odds ratio, 1.06 at 95 % confidence interval, from 0.41 to 2.73). Intracranial hemorrhages and fatal hemorrhages were absent in both groups.Conclusion There were no significant differences in hemorrhagic safety between patients with STEACS after the TLT treatment with alteplase and early treatment with ticagrelor or clopidogrel.

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