ArticleEClinicalMedicine2026
Clinical outcomes of invasive versus conservative strategies for very high-risk patients with non-ST-elevation acute coronary syndrome: an observational cohort study in a real-world population of China.
Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Although an invasive strategy (IS) within 2 h is recommended for very high-risk patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), the optimal strategies remained debated due to a lack of evidence, because these patients were excluded from clinical studies. Therefore, we aimed to evaluate whether IS was associated with lower in-hospital and long-term all-cause death compared with conservative therapy among such patients, and whether the timing of IS differentially affected patient prognosis. Methods: This retrospective observational study recruited very high-risk patients with NSTE-ACS registered in the Chinese Cardiovascular Association Database-Chest Pain Centre between January 2015 and April 2021. Patients were grouped as receiving conservative therapy or IS within 2 h, 2-24 h, or >24 h after admission. The primary outcome was in-hospital all-cause death. Multivariable regression and inverse probability weighting analyses were conducted to account for measured confounding and assess the robustness of the findings. Findings: A total of 35,122 very high-risk patients with NSTE-ACS were finally included (mean age 64.2 years). Compared to the conservative strategy, IS at any time point (within 2 h, 2-24 h, >24 h) was associated with the reduced risk of in-hospital (adjusted odds ratio, 0.25-0.42, Interpretation: For very high-risk patients with NSTE-ACS, IS was associated with a lower risk of in-hospital and long-term all-cause death compared to conservative strategy. However, among patients who underwent invasive management, mortality outcomes were broadly similar across different timings of IS. Further randomised controlled trials are warranted to verify this finding. Funding: This work was supported by High-level Hospital Construction Project and Basic and Applied Basic Research Fund of Guangdong Province.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.