[Clinical aspects of acute coronary syndromes].
There are two types of acute coronary syndromes : those with or without ST-segment elevation. The former require urgent therapeutic measures to reopen the culprit artery (intravenous thrombolysis or primary percutaneous coronary intervention). For the latter, risk stratification is essential and is based upon clinical and biochemical markers. Among them, recent and repeated anginal attacks, ST-segment modifications on admission electrocardiogram, and increased markers of myonecrosis (particularly increased troponin levels) are strong predictors of untoward outcome. According to the risk profile, the initial management is based upon an invasive strategy with powerful antithrombotic medications and urgent angiography, or upon a non-invasive strategy using stress testing, preferably coupled with myocardial imaging techniques. In all instances, secondary prevention measures are determinant to try and stop the progression of the atherosclerotic disease.
Bensouda
Christophe
C
Département de cardiologie, Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
Otel
Irina
I
Danchin
Nicolas
N
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015415:Biomarkers; D002317:Cardiovascular Agents / Q000627:therapeutic use; D019090:Case Management; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000145:classification / Q000175:diagnosis / Q000628:therapy; D004562:Electrocardiography; D006801:Humans; D008875:Middle Aged; D009204:Myocardial Revascularization; D011379:Prognosis; D015912:Thrombolytic Therapy
D015415:Biomarkers; D002317:Cardiovascular Agents