The BCS Blog

'British Cardiovascular Society Blogging Cardiology'

NSTEMI…some like them hot but should we cool off?

The BCIS session this morning was Chaired by Simon Redwood and Bernard Prendergast (New Secretary Elect to the BCS…Congratulations!!!!!). Good attendance in the room which had housed the KBA exam for many SpRs yesterday (hope not too many bad memories for some! Good luck!)

Miles Dalby from Harefield presented an interesting case of NSTEMI opening up the debate of when to take to the cath lab…when hot or not? By not having a cooling off period with time for the antiplatelet therapy to take effect there are less risks eg of ischaemia (from embolisation), dissection etc. Not much data out there to guide us. Suggestion of benefit in troponin postives (not surprising…but then you have to wait for the 12 hour troponin so by definition not piping hot!!!) but Miles has set up a randomised study to look into timing (called DANCE…not with the wolves..or maybe?!!)….see session report on the website for more info. Also see the recent NICE guidelines on treatment unstable angine (comments please!!)….

What do you think about timing…should NSTEMI be the new PPCI?

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