title: [Acute coronary syndrome: unstable angina and myocardial infarction].
abstract: The acute coronary syndrome comprises unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction. A successful and stable revascularisation of the infarct related vessel, and the prevention of the loss of myocardium are the main therapeutic targets, as cardiovascular mortality and long term quality of life are essentially determined by left ventricular function. The clinical diagnosis comprises clinical symptoms, ECG-changes, and cardiac troponins. Early percutaneous coronary intervention (PCI) has become the most common method of coronary revascularisation. If PCI is not available, systemic thrombolysis is an alternative after exclusion of contraindications. Parenteral anticoagulation with intravenous or subcutaneous heparines, antithrombotic therapy and HMG-CoA reductase inhibitors are the common secondary drug therapy. Moreover, to prevent left ventricular remodelling ACE-inhibitors, angiotension 2-receptor antagonists, and beta-blocker are indicated.
authors.affiliation: Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Klinik und Poliklinik B, Heinrich-Heine-Universität Düsseldorf. kelm@med.uni-duesseldorf.de
authors.forename: M
authors.initials: M
authors.lastname: Kelm
authors.forename: B E
authors.initials: BE
authors.lastname: Strauer
mesh_terms: D000208:Acute Disease; D000789:Angina, Unstable / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage; D003327:Coronary Disease / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D003328:Coronary Thrombosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D004562:Electrocardiography; D017052:Hospital Mortality; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D009204:Myocardial Revascularization; D011379:Prognosis; D015996:Survival Rate; D013577:Syndrome; D015912:Thrombolytic Therapy; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
chemical_list: D000925:Anticoagulants