N Engl J Med May 2009 PMID 19458363

Early versus delayed invasive intervention in acute coronary syndromes.

Shamir R Mehta, Christopher B Granger, William E Boden, Philippe Gabriel Steg, Jean-Pierre Bassand, David P Faxon, Rizwan Afzal, Susan Chrolavicius, Sanjit S Jolly, Petr Widimsky, Alvaro Avezum, Hans-Jurgen Rupprecht, Jun Zhu, Jacques Col, Madhu K Natarajan

Mentions

29
Peak: 15 in Jan 2020
across 5 sources since Jan 2019

Extended reach

667,840
potential audience

Total likes

50

Video views

462

Mentions per month

Jan 2019 – Oct 2025

Where it's discussed

  • X / Twitter19 posts
  • News3 articles
  • Blogs3 articles
  • YouTube2 videos
  • Facebook2 posts

AI synopsis

What people are saying

The posts show a balanced view, noting that early intervention generally offers limited benefits except in high-risk groups, exemplified by mentions of the TIMACS trial and the GRACE risk score. The tone combines clinical references with discussions of practical implications, emphasizing the ongoing debate on timing and patient risk factors.

AgreementModerate agreement

Most posts acknowledge that early intervention doesn't significantly benefit all patient groups but highlight benefits in high-risk individuals, showing moderate agreement with the study findings.

InterestModerate interest

Discussions reveal curiosity about the nuances of timing and risk stratification, indicating moderate engagement and interest in the topic.

EngagementModerate engagement

Users reference specific studies like TIMACS and mention details such as risk scores and clinical implications, demonstrating active engagement.

ImpactModerate impact

The conversations reflect an understanding that the research impacts clinical decision-making, especially concerning high-risk patients, indicating a moderate perceived impact.

Abstract in brief

  • Early invasive intervention in patients with acute coronary syndromes without ST-segment elevation tends to reduce secondary adverse outcomes like death, myocardial infarction, or refractory ischemia, particularly in high-risk patients.
  • The study compared immediate (around 14 hours) versus delayed (around 50 hours) coronary angiography and found no significant difference in the main outcome of death, MI, or stroke at 6 months, but early intervention showed benefit in reducing certain secondary outcomes.
  • The benefits of early intervention were most evident in high-risk patients, whereas low-to-intermediate risk patients did not see significant differences, indicating that timing of treatment might need to be tailored based on patient risk levels.

Top posts

Most liked on X and Bluesky
C. Michael Gibson MD
@CMichaelGibson · X

The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheterization vs a delayed catheterization (>36 hours) in ACS without ST elevation https://t.co/1H6QLDlAsa https://t.co/3YhGNIKUNz

Jan 14, 2020 · 20 likes · 10 shares · 430,729 followers View post →
David J. Cohen, MD, MSc
@djc795 · X

@yuripridemd @GruentzigG @GoodishIntent @GreggWStone @jaygirimd @haiderwarraich @hectortamezmd @aspergian1 @Radial_ICG @PLooserMD @MarkELindsay @rwyeh @PradTummala @Allison_Dupont I’m not fully up to date on the guidelines, but the literature on this is pretty clear that the only patients who benefit from very early cath are those with a GRACE risk score >140 (TIMACS trial). https://t.co/QNgToEmCM5

Jan 14, 2020 · 7 likes · 19,105 followers View post →
David J. Cohen, MD, MSc
@djc795 · X

@CMichaelGibson TIMACS... https://t.co/QNgToEmCM5

Jan 14, 2020 · 5 likes · 3 shares · 19,105 followers View post →
David J. Cohen, MD, MSc
@djc795 · X

@kjdelay1 @HeartOTXHeartMD @DrMarthaGulati @DBelardoMD There are a few trials-- the best one is probably TIMACS, which suggested no overall benefit but a subgroup analysis showed a reduction in patients with a GRACE risk score >140. https://t.co/kZNWRh1tYz

May 21, 2021 · 2 likes · 19,105 followers View post →
Dr. Pedro A. Carrillo Moreno
@cardiodocpedro · X

Jun 12, 2022 · 2 likes · 4,236 followers View post →
Dr. Abdullah Alrajhi د.عبدالله الراجحي
@DAbdullahSharaf · X

Everyday-Trial# TIMACS 2009 In patients with UA/NSTEMI, early intervention (<24hrs) led to no difference in mortality or cardiovascular events when compared to delayed intervention (>36hrs), except in patients at high risk (GRACE > 140) https://t.co/xaoSaD011x

Jun 5, 2024 · 2 likes · 354 followers View post →

All mentions

Dr. Abdullah Alrajhi د.عبدالله الراجحي
@DAbdullahSharaf · X

Everyday-Trial# TIMACS 2009 In patients with UA/NSTEMI, early intervention (<24hrs) led to no difference in mortality or cardiovascular events when compared to delayed intervention (>36hrs), except in patients at high risk (GRACE > 140) https://t.co/xaoSaD011x

Jun 5, 2024 · 2 likes · 354 followers View post →
Dr. Pedro A. Carrillo Moreno
@cardiodocpedro · X

Jun 12, 2022 · 2 likes · 4,236 followers View post →
David J. Cohen, MD, MSc
@djc795 · X

@kjdelay1 @HeartOTXHeartMD @DrMarthaGulati @DBelardoMD There are a few trials-- the best one is probably TIMACS, which suggested no overall benefit but a subgroup analysis showed a reduction in patients with a GRACE risk score >140. https://t.co/kZNWRh1tYz

May 21, 2021 · 2 likes · 19,105 followers View post →
Ted Dodge
@TedDodgeMD · X

RT @djc795: @CMichaelGibson TIMACS... https://t.co/QNgToEmCM5

Jan 15, 2020 · 3 shares · 735 followers View post →
Mihai Trofenciuc
@MihaiTrofenciuc · X

RT @CMichaelGibson: The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheteriz…

Jan 15, 2020 · 10 shares · 3,865 followers View post →
IANCARDIOLOGY
@CardioIAN · X

RT @CMichaelGibson: The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheteriz…

Jan 15, 2020 · 10 shares · 8,253 followers View post →
Javier de Juan
@JavierdeJuan1 · X

RT @CMichaelGibson: The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheteriz…

Jan 15, 2020 · 10 shares · 1,699 followers View post →
Hany Ragy
@Hragy · X

RT @CMichaelGibson: The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheteriz…

Jan 15, 2020 · 10 shares · 80,664 followers View post →
Zorba Blázquez Bermejo
@ZorbaBlazquez · X

RT @CMichaelGibson: The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheteriz…

Jan 15, 2020 · 10 shares · 1,152 followers View post →
Dr Elif
@helifcal · X

RT @CMichaelGibson: The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheteriz…

Jan 15, 2020 · 10 shares · 1,382 followers View post →
Erhan Tenekecioğlu
@drercardio · X

RT @CMichaelGibson: The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheteriz…

Jan 15, 2020 · 10 shares · 65,426 followers View post →
Matthew-qiao
@Matthew_Qiao · X

RT @CMichaelGibson: The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheteriz…

Jan 14, 2020 · 10 shares · 55 followers View post →
Tony Vo
@tonyhvo · X

RT @djc795: @CMichaelGibson TIMACS... https://t.co/QNgToEmCM5

Jan 14, 2020 · 3 shares · 880 followers View post →
IANCARDIOLOGY
@CardioIAN · X

RT @djc795: @CMichaelGibson TIMACS... https://t.co/QNgToEmCM5

Jan 14, 2020 · 3 shares · 8,253 followers View post →
Alex Kharlamov MD FESC FACC FEACVI FAHA
@drskharlamov · X

RT @CMichaelGibson: The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheteriz…

Jan 14, 2020 · 10 shares · 1,669 followers View post →
C. Michael Gibson MD
@CMichaelGibson · X

The TIMACS study also did not show a benefit in reducing death/MI/stroke with an immediate/early (<24 hours) catheterization vs a delayed catheterization (>36 hours) in ACS without ST elevation https://t.co/1H6QLDlAsa https://t.co/3YhGNIKUNz

Jan 14, 2020 · 20 likes · 10 shares · 430,729 followers View post →
David J. Cohen, MD, MSc
@djc795 · X

@CMichaelGibson TIMACS... https://t.co/QNgToEmCM5

Jan 14, 2020 · 5 likes · 3 shares · 19,105 followers View post →
David J. Cohen, MD, MSc
@djc795 · X

@yuripridemd @GruentzigG @GoodishIntent @GreggWStone @jaygirimd @haiderwarraich @hectortamezmd @aspergian1 @Radial_ICG @PLooserMD @MarkELindsay @rwyeh @PradTummala @Allison_Dupont I’m not fully up to date on the guidelines, but the literature on this is pretty clear that the only patients who benefit from very early cath are those with a GRACE risk score >140 (TIMACS trial). https://t.co/QNgToEmCM5

Jan 14, 2020 · 7 likes · 19,105 followers View post →
Ethical GmbH
@Ethicalgmbh · X

Early versus Delayed Invasive Intervention in Acute Coronary Syndromes | NEJM https://t.co/J0vrcP2kX5

Jan 15, 2019 · 487 followers View post →