Integrating antithrombin and antiplatelet therapies with early invasive management for non-ST-segment elevation acute coronary syndromes.
Non-ST-segment elevation acute coronary syndromes are a dramatic manifestation of coronary artery disease. Multiple clinical trials have shown that early cardiac catheterization improves clinical outcomes in patients with non-ST-segment elevation acute coronary syndromes. Many antithrombotic agents effectively manage unstable coronary syndromes and serve as adjuncts to percutaneous coronary intervention. Yet, the growing number of pharmacologic agents makes early management of non-ST-segment elevation acute coronary syndromes increasingly complex. We review the current evidence regarding the optimal integration of early antithrombotic and antiplatelet therapies with early coronary angiography and subsequent revascularization.
Rebeiz
Abdallah G
AG
Duke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, North Carolina 27715, USA. rebei001@onyx.dcri.duke.edu
Roe
Matthew T
MT
Alexander
John H
JH
Mahaffey
Kenneth W
KW
Granger
Christopher B
CB
Peterson
Eric D
ED
Califf
Robert M
RM
Harrington
Robert A
RA
D000465:Algorithms; D006328:Cardiac Catheterization; D000077144:Clopidogrel; D017023:Coronary Angiography; D000077542:Eptifibatide; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D039661:Integrin beta3; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D010455:Peptides / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D018570:Risk Assessment; D015912:Thrombolytic Therapy; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D039661:Integrin beta3; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077144:Clopidogrel; D000077542:Eptifibatide; D013988:Ticlopidine