(September 2, 2009 - Insidermedicine)

Individuals suffering from a relatively stable form of an acute coronary syndrome do not benefit from urgent, immediate invasive treatment the way a more unstable patient might, according to research published in the latest issue of the Journal of the American Medical Association.

Here is some information on acute coronary syndromes:

•    It refers to a number of conditions in which blood supply to the heart is dangerously limited, including heart attacks

•    While all acute coronary syndromes are emergencies, some types are more urgent than others

•    In general, a person experiencing an acute coronary syndrome with evidence on an electrocardiogram (or ECG) of something known as ST-elevation are in worse shape than those without ST-elevation.

Researchers from the Centre Hospitalier Universitaire Pitie-Sapetriere in Paris randomly assigned over 350 patients with non-ST-segment elevation acute coronary syndromes to receive urgent invasive treatment as soon as possible or only on the next working day. The invasive treatment consisted of threading a balloon-tipped catheter into the blockage in the coronary artery to open it up and possibly inserting a stent in that location to keep it open.

On average, patients assigned to the immediate-therapy group received treatment within about 70 min of being randomized, while the delayed-care group received it only about 21hrs later. Nonetheless, both groups of patients had similar outcomes after one month. While in hospital, they also had similar peak levels of troponin, a substance that is released when the heart muscle undergoes damage.

Today’s research suggests that patients with more stable forms of acute coronary syndromes do just as well if their invasive treatment is delayed for a day or two than if they received treatment right away.