A recent study suggests that patients with non-ST-elevation acute coronary syndrome (ACS) may want to hold off on invasive cardiac surgery soon after hospitalization.
A total of 18,151 patients with non-ST-elevation ACS were enrolled in the Organization to Assess Strategies for Ischemic syndromes (OASIS) and the OASIS-2 trials. Data from the two studies were pooled and analyzed to determine the prognostic factors for stroke in this group of patients. Overall, over a 6-month follow-up period, 238 patients had a stroke and multivariate regression analysis identified coronary artery bypass graft (CABG) as the most important predictor of stroke. Furthermore, patients who underwent early CABG surgery were at a substantially increased risk when compared with those who had later CABG. Other prognostic factors identified included history of stroke, diabetes mellitus older age, higher heart rate and on-site catheterization facility. No increased stroke risk was identified for patients who underwent percutaneous coronary intervention.
Source
- Cronin LC, Mehta SR, Zhao F, et al. Stroke in relation to cardiac procedures in patients with non-ST-elevation acute coronary syndrome. Circulation. 2001;104;269-274.
