Iranian Heart Association Iranian Heart Journal 27 2 2026 04 01 Immediate vs Standard Percutaneous Coronary Intervention Timing in Patients Presenting With Non–ST-Segment Elevation Myocardial Infarction 38 46 242138 EN Ahmed Nabih Awad Abdelrazik Hawass Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Ahmed Abdelrahman Sharaf Eldin Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Ahmed Fathy Tamara Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Abd El Rahman Elsayed Attia Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Journal Article 2025 03 30 Background: The optimal timing for percutaneous coronary intervention (PCI) in patients with non–ST-segment elevation myocardial infarction (NSTEMI) remains a matter of clinical debate, particularly in high-risk but stable patients. This study aimed to evaluate whether immediate PCI (within the timeframe of primary PCI) improves clinical outcomes compared with standard early PCI (within 24 hours) in high-risk NSTEMI patients. Methods: This prospective, single-center, randomized study included 300 high-risk NSTEMI patients at Ain Shams University hospitals. Patients were randomized to either immediate PCI (n = 150) or standard PCI (n = 150). Baseline characteristics, electrocardiographic (ECG) findings, echocardiographic findings, coronary angiography results, length of hospital stay, and 1- and 6-month major adverse cardiovascular events (MACE) were assessed. Results: Time to angiography was significantly shorter in the immediate PCI group (1.493 ± 0.288 h vs 13.200 ± 4.780 h; P < 0.001). Hospital stay was significantly reduced in the immediate PCI group (1.447 ± 0.651 vs 2.293 ± 0.765 d; P < 0.001). No significant differences were observed in ECG findings, ejection fraction, infarct-related artery occlusion rates, or vessel distribution (P > 0.05). At 1 month, MACE occurred in 5.33% vs 7.33% (P = 0.477); at 6 months, in 11.33% vs 18.67% (P = 0.075) in immediate vs standard PCI groups, respectively. Conclusions: Immediate PCI does not reduce short- or mid-term MACE compared with standard PCI, but it is associated with a significantly shorter hospital stay, supporting its role in optimizing healthcare efficiency. (Iranian Heart Journal 2026; 27(2): 38-46)

https://journal.iha.org.ir/article_242138_5b33891bf1a8599bea0e14961e5ed666.pdf