Immediate Versus Delayed Coronary Angiography in Patients With Non-ST-Segment Acute Coronary Syndrome with Acute Decompensated Heart Failure

Chonnam National University Hospital0 个研究点目标入组 316 人开始时间: 待定最近更新: 2024年3月4日

适应症

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•1) Age more than 18 years old
•2) NSTE-ACS*
•3) Pulmonary congestion or edema on chest X-ray
•* The definition of NSTE-ACS
•Among patients with typical angina, dyspnea or chest discomfort without definite non-cardiac causes, at least 1 presentations of angina that suggest an NSTE-ACS:
•1) Rest angina, which is usually more than 20 minutes in duration
•2) New onset angina that markedly limits physical activity
•3) Increasing angina that is more frequent, longer in duration, or occurs with less exertion than previous angina
•A 12-lead electrocardiogram should have no ST-segment elevation. Cardiac troponin may elevate (non-ST-segment elevation myocardial infarction) or not elevate (unstable angina pectoris).

•1) Cardiogenic shock*
•2) Heart failure of other causes rather than NSTE-ACS
•3) Terminal malignancy
•4) Life expentancy < 1 year
•5) Pregnancy or lactation
•* The definition of cardiogenic shock
•All these criteria should be met
•1) Systolic blood pressure < 90 mmHg for 30 minutes, or needing inotropics or vasopressor to maintain systolic blood pressure > or = 90 mmHg
•2) Pulmonary congestion on chest X-ray or increased left ventricular filling pressure by cardiac catheterization
•3) At least one criteria of organ dysfunction
•- mental obtundation, clammy ski, ogliuria, renal dysfunction, increased level of blood lactate

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