Elective coronary angioplasty in acute coronary syndromes: early versus delayed treatment]

In patients with acute coronary syndromes (ACS) the optimal time required to stabilize the patient before attempting coronary intervention (PTCA) is uncertain. The recent use of newer devices and antiplatelet drugs allowed earlier percutaneous intervention.We examined the efficacy and safety of coronary angioplasty in patients with ACS according to the period of stabilization with medical therapy.We included 83 patients, 15 female, 54 with unstable angina and 29 with non-ST elevation myocardial infarction. We studied the rate of complications related to the procedure, the duration of CCU and hospital stay according to the period of stabilization with medical therapy: < 48 hours (early PTCA) and > or = 48 hours (delayed PTCA).No significant differences were found between the two groups of patients with respect to success rate (92% in early PTCA vs 98% in delayed PTCA), stents implantation (74% vs 78%), use of abeiximab (42% vs 24%), abrupt closure during procedure (3% vs 2%), infarct related procedure (0% vs 7%), re-PTCA (5% vs 7%) and surgical revascularization (0% vs 2%). No deaths occurred, CCU stay (2.5 vs 6.7 days, p < 0.001) and hospital stay (4 vs 9.4 days, p = 0.001) were significantly shorter in the group of early PTCA.In the present group of patients with ACS, early coronary intervention was a safe procedure with a shorter CCU and hospital stay compared with deferred PTCA.