{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T16:02:55Z","timestamp":1781884975094,"version":"3.54.5"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Science and Technology Project of Tianjin Municipal Health Committee","award":["TJWJ2022MS009"],"award-info":[{"award-number":["TJWJ2022MS009"]}]},{"name":"Science and Technology Project of Tianjin Municipal Health Committee","award":["TJWJ2024RC004"],"award-info":[{"award-number":["TJWJ2024RC004"]}]},{"name":"Tianjin Municipal Key Research Project in Priority Areas of Traditional Chinese Medicine","award":["2022011"],"award-info":[{"award-number":["2022011"]}]},{"name":"Key Science and Technology Support Project of Tianjin Science and Technology Bureau","award":["24ZXGZSY00130"],"award-info":[{"award-number":["24ZXGZSY00130"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82470527"],"award-info":[{"award-number":["82470527"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tianjin Key Medical Discipline Construction","award":["TJYXZDXK-3-006B"],"award-info":[{"award-number":["TJYXZDXK-3-006B"]}]},{"name":"National Health Commission Hospital Management Research Project of China","award":["NIHA23JXH009"],"award-info":[{"award-number":["NIHA23JXH009"]}]},{"name":"National Science and Technology Innovation 2030","award":["2024ZD0524300"],"award-info":[{"award-number":["2024ZD0524300"]}]},{"name":"National Science and Technology Innovation 2030","award":["2024ZD0524301"],"award-info":[{"award-number":["2024ZD0524301"]}]},{"name":"Academic Backbone of \u201cClinical Talent Training and Climbing Plan\u201d of Tianjin Medical University"},{"name":"\u201cJinmen Medical Talent\u201d of Tianjin Health Industry High-Level Talent Selection and Training Project","award":["TJSJMYXYC-D2-046"],"award-info":[{"award-number":["TJSJMYXYC-D2-046"]}]},{"name":"Key Research Project of Tianjin Education Commission","award":["2024ZD031"],"award-info":[{"award-number":["2024ZD031"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non\u2013ST-segment elevation myocardial infarction (NSTEMI) represents a substantial proportion of acute coronary syndrome and is associated with considerable morbidity and mortality. Pulmonary hypertension (PH) is linked to adverse cardiovascular outcomes and may complicate management decisions in NSTEMI. However, evidence regarding the optimal treatment strategy for NSTEMI patients with PH remains limited. This study evaluated the association between invasive versus conservative management and short- and long-term outcomes in a real-world multicenter cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective multicenter cohort study used data from the Tianjin Health and Medical Big Data Super Platform. Adult patients hospitalized with NSTEMI and concomitant PH between January 2010 and March 2023 were included. Patients were categorized according to treatment strategy during the index hospitalization (invasive vs. conservative management). The primary outcome was 1-year major adverse cardiovascular events (MACE), defined as cardiac death, recurrent myocardial infarction, ischemic stroke, or repeat revascularization. Propensity scores were estimated using logistic regression. The primary analysis used inverse probability of treatment weighting with doubly robust Cox regression models, with additional sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 985 patients with NSTEMI and PH, 243 (24.7%) received invasive management and 742 (75.3%) conservative treatment. In doubly robust Cox models, invasive management was associated with a lower risk of 1-year MACE (adjusted hazard ratio [aHR] 0.60, 95% CI 0.41\u20130.88, P = 0.009) and cardiac death (aHR 0.54, 95% CI 0.34\u20130.87, P = 0.011). However, bleeding risk was higher in the invasive group (aHR 2.86, 95% CI 1.34\u20136.11, P = 0.007).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Invasive management was associated with fewer ischemic events but a higher risk of bleeding in patients with NSTEMI and PH, highlighting the need for individualized treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121261449544","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T02:36:46Z","timestamp":1778121406000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Invasive versus non-invasive management in non-ST segment elevation myocardial infarction patients with pulmonary hypertension"],"prefix":"10.1177","volume":"14","author":[{"given":"Ze","family":"Zhang","sequence":"first","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianshu","family":"Gu","sequence":"additional","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haonan","family":"Xu","sequence":"additional","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukun","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sutao","family":"Hu","sequence":"additional","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaying","family":"Fu","sequence":"additional","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiding","family":"Wang","sequence":"additional","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Liu","sequence":"additional","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian","family":"Shao","sequence":"additional","affiliation":[{"name":"Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wang","sequence":"additional","affiliation":[{"name":"Chest Hospital of Tianjin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjian","family":"Li","sequence":"additional","affiliation":[{"name":"Tianjin Medical University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Liu","sequence":"additional","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7056-6438","authenticated-orcid":false,"given":"Kang-Yin","family":"Chen","sequence":"additional","affiliation":[{"name":"The Second Hospital of Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.11.009"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa575"},{"key":"e_1_3_8_4_2","first-page":"407","article-title":"Effect of Routine Invasive vs Conservative Strategy in Older Adults With Frailty and Non-ST-Segment Elevation Acute Myocardial Infarction: A Randomized Clinical Trial","volume":"183","author":"J S","unstructured":"J S, H B, G M, et al. Effect of Routine Invasive vs Conservative Strategy in Older Adults With Frailty and Non-ST-Segment Elevation Acute Myocardial Infarction: A Randomized Clinical Trial. 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