Revised guidelines for the management of non-ST-segment elevation acute coronary syndromes.
Unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) refer to a spectrum of acute severe cardiac disorders characterized by myocardial oxygen demand and supply mismatch, caused by atherosclerotic coronary artery disease. Patients presenting with acute coronary syndromes represent a major medical problem, accounting for 2.5 million hospitalizations and 500000 deaths annually in the United States alone. Of these, 1.5 million have a final diagnosis of UA, and myocardial infarction (ST-segment and non-ST-segment elevation) accounts for the remaining 1 million. The management of UA/NSTEMI presents a challenge to the cardiologist because treatment strategies continue to evolve. A number of trials have now assessed the safety and efficacy of early revascularization strategies in the treatment of patients with UA/NSTEMI, whereas others have focused on pharmacologic adjunctive therapy. An optimal single strategy encompassing most patients' needs is not clear. This review focuses on the revised American College of Cardiology/American Heart Association guidelines for the management of patients presenting with UA/NSTEMI.
Mukherjee
Debabrata
D
Division of Cardiology, University of Michigan Health System, 3910 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48103, USA. keagle@umich.edu
Eagle
Kim A
KA
D000208:Acute Disease; D000572:American Heart Association; D000789:Angina, Unstable / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D002309:Cardiology / Q000592:standards*; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012955:Societies, Medical / Q000592:standards; D013577:Syndrome; D014481:United States