[Acute coronary syndromes without ST elevation. State-of-the-art, recommendations, and best practices].
In the last decade, acute coronary syndromes without ST elevation (ACS ST-) have become a clinical entity encompassing previous technologies such as acute coronary insufficiency and non-Q wave myocardial infarction. The recognition of its risks and, above all, the development and adaptation of medical and interventional strategies have transformed the prognosis. Patients presenting with ACS ST- are not all identical and do not all have the same prognosis; based on this observation, a number of prognostic scores have been proposed which help decide whether to use drugs such as GP IIb/IIIa inhibitors or coronary angioplasty. Conservative and aggressive strategies are opposing choices but risk stratification allows the treating physician to take a safe decision in the majority of cases. Besides angioplasty and GP IIb/IIIa inhibitors, the basic treatment (aspirin, low molecular weight heparin, clopidogrel, betablockers) should of course be prescribed and its efficacy has contributed to a better outcome in these patients. The recommendations of the scientific societies have evolved with time and increased understanding, allowing an evidence-based approach to the management of ACS ST- patients.
Blanchard
D
D
Clinique Saint-Gatien, Tours. Didier.Blanchard@wanadoo.fr
Chevalier
B
B
Eltchaninoff
H
H
D000465:Algorithms; D000789:Angina, Unstable / Q000401:mortality / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers; D003663:Decision Trees; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D018570:Risk Assessment
D015415:Biomarkers