Abstract 12626: Predictors of Initial Revascularization versus Medical Therapy in Patients With Non-ST Segment Elevation Acute Coronary Syndrome Undergoing an Invasive Strategy

Background: Although an invasive strategy is a Class I clinical practice guideline for non-ST-segment elevation acute coronary syndromes (NSTE-ACS), there is wide variation in the proportion of such patients who undergo revascularization despite early angiography. We sought to identify the predictors of early revascularization versus medical therapy alone in NSTE-ACS patients undergoing an invasive strategy and contrast their clinical outcomes. Methods: We assessed revascularization status (PCI or CABG within 7 days of the index angiogram) in all NSTE-ACS patients treated with an invasive strategy at 18 hospitals in Ontario, Canada from October 1st 2008 to October 31st, 2013, using the Cardiac Care Network registry. Follow-up was until December 31st, 2014. The primary outcome was death. Multivariable, hierarchical logistic models were used to identify predictors of revascularization. Multivariable Cox models with treatment strategy as a 3-level time-varying covariate were developed to understand the relat...