title: Management of high-risk non-ST elevation myocardial infarction in the UK: need for alternative models of care to reduce length of stay and admission to angiography times.
abstract: The roll out of the primary percutaneous coronary intervention pathway as the default treatment for patients with ST elevation myocardial infarction (STEMI) across the NHS has led to a paradigm shift in the model of care resulting in a significant improvement in mortality. In comparison, a similar care plan does not exist for non-ST elevation acute coronary syndrome (NSTE-ACS) despite the fact that patients presenting with high-risk non-STEMI carry a similar if not higher mortality at six months in comparison to STEMI. In this article we focus on the contemporary management of NSTE-ACS in the NHS and also look at some of the dedicated pathways already developed and implemented successfully in expediting treatment and decreasing hospital stay without compromising the safety of patients.
authors.affiliation: Department of Cardiology, Royal Free Hospital, London, UK, and UCL Institute of Cardiovascular Science, London, UK.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Koganti
authors.affiliation: Department of Cardiology, Royal Free Hospital, London, UK, and UCL Institute of Cardiovascular Science, London, UK roby.rakhit@nhs.net.
authors.forename: Roby D
authors.initials: RD
authors.lastname: Rakhit
mesh_terms: D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003661:Decision Support Techniques; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008485:Medical Audit; D008962:Models, Theoretical; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy*; D013222:State Medicine; D006113:United Kingdom
keywords: NHS; NSTE-ACS; NSTEMI; dedicated pathways; hospital stay