6/30/23, 2:17 AM TIMACS Pathway Feedback Search Clinical Topics Home Studies TIMACS TIMACS Disease Disease Coronary artery disease Non-ST-elevation myocardial inf Trial question What is the role of early invasive intervention in patients with acute coronary syndromes? Study design Multi-center Open label RCT Population Characteristics of study participants 35.0% female N = 3031 65.0% male 3031 patients (1050 female, 1981 male) Inclusion criteria: patients with acute coronary syndromes Key exclusion criteria: not a suitable candidate for coronary revascularization, comorbidity with life expectancy < 6 months, or age < 21 years Interventions N=1593 early intervention (coronary angiography 24 hours after randomization) N=1438 delayed intervention (coronary angiography 36 hours after randomization) Primary outcome Death, myocardial infarction, or stroke at 6 months 11.3 % 11.3 https://web.pathway.md/studies/recCxNlqrEEfp7hH1 1/2 6/30/23, 2:17 AM TIMACS Pathway 3 9.6 8.5 % 5.7 % 2.8 % No significant difference 0.0 % Early intervention Delayed intervention No significant difference in death, myocardial infarction, or stroke at 6 months (9.6% vs. 11.3%; HR 0.85, 95% CI 0.68 to 1.06) Secondary outcomes Significant decrease in death, myocardial infarction, or refractory ischemia at 6 months (9.5% vs. 12.9%; HR 0.72, 95% CI 0.58 to 0.89) Significant decrease in death, myocardial infarction, or refractory ischemia at 6 months in high-risk patients (13.9% vs. 21%; HR 0.65, 95% CI 0.48 to 0.89) No significant difference in death, myocardial infarction, or refractory ischemia at 6 months in low- to-intermediate risk patients (7.6% vs. 6.7%; HR 1.12, 95% CI 0.81 to 1.56) Safety outcomes No significant differences in major bleeding, intracranial hemorrhage, need for surgical intervention to stop bleeding, or retroperitoneal hemorrhage. Conclusion In patients with acute coronary syndromes, early intervention was not superior to delayed intervention with respect to death, myocardial infarction, or stroke at 6 months. Reference Mehta SR, Granger CB, Boden WE et al. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med. 2009 May 21;360(21):2165-75. Open reference URL https://web.pathway.md/studies/recCxNlqrEEfp7hH1 2/2