[Antithrombotic therapy for non-ST segment elevation myocardial infarction].
Non-ST segment elevation myocardial infarction (NSTEMI) is an acute life-threatening event which has a high rate of recurrence. Combined antithrombotic therapy (including cacetylsalicylic acid, clopidogrel, heparins and glycoprotein IIb/IIIa receptor antagonists) substantially reduced major coronary events during the acute phase of coronary heart disease with a good tolerance because of the short duration of such aggressive strategy. The combined antithrombotic strategy also allows to increase the benefit of an early invasive strategy including coronary angiogram with stent percutaneous coronary angioplasty which recent trials have shown that to be preferable to a conservative approach in these high risk patients. Antithrombotic and antiplatelet therapy in association with coronary revascularization play an important role in the prevention of an adverse outcome. Recently, clopidogrel has been shown reduce recurrent ischaemic events, both early and during the first year after non-ST-segment elevation myocardial infarction. An ideal antithrombotic and antiplatelet strategy will reduce events before revascularization, enhance the revascularization procedure without excessive bleeding.
Hölschermann
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Chefarzt der Inneren Medizin I, Kardiologie/Angiologie, Hochtaunus-Kliniken, Krankenhaus Bad Homburg, Urseler Strasse 33, 61348 Bad Homburg.