Treatment of acute coronary syndrome: Part 1: Non-ST-segment acute coronary syndrome

Jeffrey C. Trost, Richard A. Lange

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: Acute coronary syndrome is a common cause of morbidity and mortality, both in the United States and worldwide. The goal of this review is to familiarize clinicians with recent information regarding the diagnosis and treatment of acute coronary syndrome. Data Sources: PubMed search and review of the relevant medical literature. Summary: Acute coronary syndrome encompasses three clinical diagnoses: unstable angina, non-ST-segment elevation myocardial infarction), and ST-segment elevation myocardial infarction. The definition, pathophysiology, clinical presentation, diagnosis, and treatment of unstable angina/non-ST-segment elevation myocardial infarction are reviewed here. Diagnosing unstable angina/non-ST-segment elevation myocardial infarction is a significant challenge in critically ill patients not initially suspected of having acute coronary syndrome (i.e., noncardiac intensive care unit patients), and diagnostic and treatment strategies for these patients have not been clearly established. Conclusions: Patients with acute coronary syndrome benefit from intensive medical therapy, including antianginal, antiplatelet, antithrombotic, and statin agents. Depending on their risk for future cardiovascular events as well as their risk of bleeding complications, patients may benefit from either an early invasive treatment strategy, in which routine coronary revascularization is performed, or a conservative strategy, in which revascularization is reserved for patients with recurrent or provocable cardiac ischemia.

Original languageEnglish (US)
Pages (from-to)2346-2353
Number of pages8
JournalCritical care medicine
Volume39
Issue number10
DOIs
StatePublished - Oct 2011

Keywords

  • acute coronary syndrome
  • acute myocardial infarction
  • coronary artery disease
  • unstable angina

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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