TRENDS AND OUTCOMES OF CORONARY ANGIOGRAPHY IN ACUTE CORONARY SYNDROME: A DECADE'S PERSPECTIVE

Abstract

Importance: coronary angiography is crucial in acute coronary syndrome (ACS) for precise diagnosis, risk assessment, and guiding therapeutic interventions. It allows clinicians to identify culprit lesions, determine revascularization needs, and optimize medical therapy. Timely angiography reduces ischemic events, improves outcomes, and aids long-term prognostication. Overall, it plays a pivotal role in enhancing the care and management of ACS patients.

Objective: The objective of coronary angiography in acute coronary syndrome (ACS) is to provide precise diagnosis, assess the extent and severity of coronary artery disease, guide therapeutic interventions such as revascularization, optimize medical therapy, reduce ischemic events, and improve long-term outcomes. It aims to enhance the care and management of ACS patients by facilitating timely and targeted interventions based on individual patient characteristics and coronary anatomy.

Background: Coronary angiography serves as the cornerstone of diagnostic evaluation in acute coronary syndrome (ACS), enabling clinicians to visualize coronary arteries and identify obstructive lesions responsible for ischemic events. It plays a vital role in risk stratification, guiding therapeutic decisions, and optimizing patient management strategies. Through precise visualization of coronary anatomy, coronary angiography aids in the timely implementation of revascularization procedures and adjunctive pharmacotherapy, ultimately improving outcomes and prognosis for ACS patients.

Conclusion: A reduction in the time to coronary angiography correlated with fewer ischemic events and no increase in bleeding. Randomized clinical trials are necessary to provide definitive evidence on the optimal timing of coronary angiography but are challenging to design and execute. Instead, ongoing trials should aim to clarify whether delaying angiography to administer aggressive upstream antithrombotic therapies is effective in the current management of NSTE-ACS.