Very early invasive strategy in higher risk non-ST-elevation acute coronary syndrome: the RAPID NSTEMI trial
Primary result · All-cause mortality, new MI or hospitalisation for HFResult — go to the resultOdds ratio 0.93 95% CI 0.42–2.09- discontinued early
- Discontinued early by the funder due to slow recruitment during the COVID-19 pandemic
Authors' conclusion
A strategy of very early IS did not improve clinical outcomes compared with a standard care IS in higher risk patients with NSTE-ACS.
Study context
- Population
- Higher risk patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) (GRACE 2.0 score ≥118, or ≥90 with ≥1 additional high-risk feature)413 underwent an invasive strategy (IS)
- Participants
- 425 patients
- Comparison
- Very early IS±revascularisation vs standard care IS±revascularisation
- Very early ISn = 204
- Standard care ISn = 209reference
- Primary endpoint
- Composite of:
- All-cause mortality
- New MI
- Hospitalisation for HF
- Follow-up
- 12 months
Methodological detailsmulticentre, pragmatic strategy trial
- Multicentre
- Pragmatic strategy trial
Primary result
As reported in the abstract
All-cause mortality, new MI or hospitalisation for HF
Odds ratio
0.93
95% CI 0.42–2.09
P = 0.86
By group
Early ISvs Standard IS
OR 0.93 (95% CI 0.42–2.09); P = 0.86
Further findings
Length of hospital stay
P < 0.01
Time from randomisation to IS
Safety
- Incidence of stroke and major bleeding similar
Original publication
Very early invasive strategy in higher risk non-ST-elevation acute coronary syndrome: the RAPID NSTEMI trial. Heart. Published 16 December 2023. doi:10.
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