title: Unstable angina: current concepts of pathogenesis and treatment.
abstract: During the past 15 years, we have learned an enormous amount about the pathogenesis and treatment of unstable angina. In most cases of unstable rest angina, the pathogenesis is a mural thrombus formation on a ruptured or eroded atherosclerotic plaque. However, any process that acutely changes the supply-demand ratio (decreased supply or increased demand in the presence of a decrease in supply) can precipitate the clinical presentation of unstable angina. Standard acute antithrombotic drug therapy is effective in decreasing progression to infarction. Newer agents (low-molecular-weight heparin and platelet glycoprotein IIb/IIIa inhibitors) are more effective, and their use is evolving. Percutaneous intervention and bypass surgery can reduce symptoms and multiple hospitalizations, in most cases without a decrease in the long-term mortality rate. Because the cost of hospitalization is extremely high and the clinical presentation and outcome are heterogeneous, better triage methods are required.
authors.affiliation: Comprehensive Cardiovascular Center, Saint Vincents Hospital and Medical Center of New York, NY 10011, USA. jambrose@saintvincentsnyc.org
authors.forename: J A
authors.initials: JA
authors.lastname: Ambrose
authors.forename: G
authors.initials: G
authors.lastname: Dangas
mesh_terms: D000789:Angina, Unstable / Q000145:classification / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy*; D017023:Coronary Angiography; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009204:Myocardial Revascularization / Q000379:methods*; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D005343:Fibrinolytic Agents