[Treatment of unstable coronary disease].
The clinical presentations of ischemic heart disease comprises the term of acute ischaemia syndromes, that include unstable angina pectoris, non-Q-wave myocardial infarction, Q-wave-myocardial infarction and sudden death. Among the different presentations of acute ischemic syndromes, the unstable angina and non-Q-wave myocardial infarction can be regarded together. In both pathologic entity, the plaque rupture, or erosion signifies the primary event, which is the source of the highly thrombogenic substances coming out from the core of the atherosclerotic plaque and entering to the coronary and systemic circulation. They cause a thrombocyte-rich "white" intracoronary thrombus, that is not fully obstructive, or there is adequate collateral circulation, being the pathogenetic substrate that prevents the development of transmural necrosis. The nosologically-bound two clinical entity can be called as "unstable coronary artery disease" (UCAD), since they have uniform etiologic, risk stratification and therapeutic backgrounds and also therapeutic targets that are basically distinct, they are admitted for transmural "ST-elevation" infarction. The review is discussing the therapy and the questions of follow-up of the disease according to the guidelines of the European Society of Cardiology and to the multicenter evidence based studies.
Préda
István
I
Országos Gyógyintézeti Központ Kardiológiai és Belgyógyászati Osztály és Semmelweis Egyetem, II. sz. Kardiológiai Tanszék.
D000789:Angina, Unstable / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D000991:Antithrombins / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006329:Heart Conduction System / Q000503:physiopathology*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D016032:Randomized Controlled Trials as Topic; D014665:Vasodilator Agents / Q000627:therapeutic use
D000991:Antithrombins; D002317:Cardiovascular Agents; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014665:Vasodilator Agents