Does early invasive coronary angiography and revascularization in patients with non-ST-segment elevation acute coronary syndrome within 12 hours of diagnosis reduce adverse outcomes?

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Why is this study important?

Invasive coronary angiography (ICA) and revascularization compared with a conservative approach is beneficial to patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS).[1] However, the optimal timing of ICA (≤ 24 hours [h] vs. 24–72 h) is unclear. Current guidelines propose early ICA (≤ 24 h) in patients with an acute NSTE-ACS, as determined by cardiac troponin changes, new or presumed new ST-depression or Global Registry of Acute Coronary Events Score (GRACE) > 140.[2] [3] This trial sought to determine the effect of a very early (≤ 12 h of diagnosis) invasive strategy, a resource intensive and logistically challenging approach, on long-term clinical outcome in patients with NSTE-ACS.

Which, if any, threats to validity are most likely to have an impact on the results and how?

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