Should high risk NSTEMI heart attack patients have stents fitted immediately?

RAPIDNSTEMI -  Revascularisation in ACS Patients: Immediate versus Delayed Intervention A study assessing the impact of very early intervention on outcomes in NSTEMI-ACS patients

Professor Anthony Gershlick at the University of Leicester is researching how best to treat people who experience smaller heart attacks, called NSTEMI, where the affected coronary artery is not completely blocked. Currently, people who have suffered an NSTEMI heart attack go to the catheter lab, where a cardiologist opens the artery with a stent. Guidelines recommend that stenting should be performed within 72 hours of hospital admission, but we don’t know if higher risk NSTEMI patients would benefit from receiving this treatment immediately. In this RAPIDNSTEMI clinical trial, Professor Gershlick will find out whether immediate treatment or treatment within 72 hours has the best outcome for this group of patients. Around 2300 high risk NSTEMI patients will either be taken to the catheter lab and have a stent fitted immediately or will be treated within 72 hours after stabilising their condition using drugs. The team will measure the number of repeat heart attacks, admissions with heart failure, and how many patients survive over a one year follow up period. This study will determine how doctors should treat patients with NSTEMI heart attacks, and whether current clinical guidelines should be changed. It will also reveal which treatment pathway is most cost effective.