This is a pilot feasibility study to evaluate if patients with ST depression Acute Coronary Syndrome who are taken directly to the catheter laboratory for angiogram and angioplasty +/- stents will fare better that patients who are taken to the ward area and managed with drug therapy and stabilised for 24 hours before being taken to the catheter laboratory.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
108
Patients allocated to the immediate invasive strategy will be taken to the catheter lab immediately (\< 90 minutes from randomisation) in accordance with local primary angioplasty policy. Angiogram +/- same sitting PCI will be performed according to local policy and guidelines
Patients allocated to the conventional management group will have medical stabilisation and will undergo angiogram +/- PCI between 24 to 48 hours from randomisation according to local policy and guidelines
Royal Brompton And Harefield NHS Trust
Harefield, Middlesex, United Kingdom
Ambulance recruitment rate per million of population (corrected for 9-5 recruitment)
Time frame: 12 months (duration of study)
Percentage of patients recruited by the ambulance services ultimately manifesting a troponin positive Acute Coronary Syndrome(ACS) within 72 hours
Time frame: within 72 hours
Percentage of ambulance recruited patients, excluded from the trial ultimately manifesting a troponin positive ACS within 72 hours
Time frame: within 72 hours
The extent of myocardial damage will be evaluated using the area under the curve (AUC) for release of cardiac markers Creatinine Kinase Myocardial Band(CKMB) and troponin
Time frame: within 7 days
Death at 30 days
Time frame: at 30 days
Recurrent non-fatal Myocardial Infarction (MI) (after 72 hours) at 30 days
Time frame: at 30 days
Additional unplanned revascularisation at 30 days.
Time frame: at 30 days
Major bleeding
Time frame: 30 days
Stroke at 30 days
Time frame: at 30 days
Unplanned hospital stay (>72 hours)
Time frame: within 72 hours
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