Abstract
An early invasive strategy in patients who have acute coronary syndrome without ST-elevation (NSTE-ACS) can improve clinical outcome in high-risk subgroups. According to the current guidelines of the European Society of Cardiology (ESC), the majority of NSTE-ACS patients are classified as “high-risk”. We propose to prioritise patients with a global registry of acute coronary events (GRACE) risk score >140 over patients with isolated troponin rise or electrocardiographic changes and a GRACE risk score <140. We also acknowledge that same-day transfer for all patients at a high risk is not necessary in the Netherlands since the majority of Dutch cardiology departments are equipped with a catheterisation laboratory where diagnostic coronary angiography is routinely performed in NSTE-ACS patients. Therefore, same-day transfer should be restricted to true high-risk patients (in addition to those NSTE-ACS patients with very high-risk (VHR) criteria) in centres without coronary angiography capabilities.
Original language | English |
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Pages (from-to) | 131-135 |
Number of pages | 5 |
Journal | Netherlands heart journal |
Volume | 28 |
Issue number | 3 |
Early online date | 6 Nov 2019 |
DOIs | |
Publication status | Published - 1 Mar 2020 |
Keywords
- Acute coronary syndrome
- Coronary angiography
- Timing