Pathogenesis and Early Management of Non–ST-segment Elevation Acute Coronary Syndromes

2006 ◽  
Vol 24 (1) ◽  
pp. 19-35 ◽  
Author(s):  
Tomas H. Ayala ◽  
Steven P. Schulman
Keyword(s):  
Acute Coronary Syndromes ◽  
Early Management ◽  
St Segment Elevation ◽  
St Segment ◽  
Coronary Syndromes

Antiplatelet and Antithrombin Therapy for Early Management of Acute Coronary Syndromes

2004 ◽  
Vol 17 (5) ◽  
pp. 347-369
Author(s):  
Barbara S. Wiggins ◽  
Sarah Spinler
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndromes ◽  
Thrombin Inhibitor ◽  
Pharmacologic Therapy ◽  
Early Management ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Coronary Syndromes ◽  
Antithrombin Therapy

Acute coronary syndromes (ACS) are defined as either unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), or ST-segment elevation myocardial infarction (STEMI). Their management is continuously evolving in terms of pharmacologic therapy. The usual cause of ACS is the disruption of an atherosclerotic plaque leading to formation of a thrombus within a coronary artery. Initial antiplatelet and antithrombin therapy for patients with ST-segment elevation (STE) ACS includes aspirin and unfractionated heparin (UFH). Patients presenting to the hospital early may undergo percutaneous intervention (PCI) with administration of additional medications such as clopidogrel and abciximab or may receive a fibrinolytic agent. Patients with non-ST-segment elevation (NSTE) ACS receive aspirin, clopidogrel, either a low-molecular-weight heparin or UFH, and, in selected patients, a glycoprotein (GP) IIb/IIIa receptor blocker. All of these agents have shown benefit when administered to patients with ACS, but results vary depending on the type of syndrome, timing of administration, and patient’s overall risk. Their mechanism of action, role in ACS, clinical practice recommendations, adverse effects, and monitoring are reviewed. Some inherent limitations to agents such as aspirin and UFH require the need for newer treatment approaches. Therefore, newer classes of drugs such as the direct thrombin inhibitor bivalirudin and the selective factor Xa inhibitor fondaparinux are being explored as alternatives to heparins for ACS management.

VALUE OF ST-SEGMENT ELEVATION IN LEAD AVR IN PREDICTING LEFT MAIN AND OR 3-VESSEL DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROMES

2017 ◽  
pp. 59-63
Author(s):  
Thanh Hung Dieu ◽  
Anh Vu Nguyen
Keyword(s):  
Predictive Value ◽  
Acute Coronary Syndromes ◽  
Independent Predictor ◽  
Left Main ◽  
St Segment Elevation ◽  
Vessel Disease ◽  
St Segment ◽  
Coronary Syndromes ◽  
Lead Avr ◽  
Sensitivity Specificity

Objects: We assessed the ability of ST-segment elevation in lead aVR to predict left main and/or 3-vessel disease (LM/3VD) in patients with acute coronary syndromes (ACS). Meterial and Method: 410 patients with ACS, who underwent coronary angiography, were evaluated. Results: 131 (31.9%) patients have been LM/3VD. ST segment elevation > 0.05 mV in leads aVR have been an independent predictor LM/3VD with sensitivity, specificity, positive predictive value PPV) and negative predictive value (NPV) 74.0%, 78.1%, 61.4% and 86.5%, respectively (p<0.001). ST segment elevation > 0.05 mV in leads aVR with ST segment depression in leads V4-V6 have related LM/3VD with sensitivity, specificity, PPV and NPV 44.3%, 92.8%, 74.4% and 75.2%, respectively (p<0.001). ST segment elevation > 0.1 mV in leads aVR have related LM/3VD with sensitivity, specificity, PPV and NPV 51.9%, 87.1%, 65.1% and 79.4%, respectively (p<0.001). Conclusions: ST segment elevation > 0.05 mV in leads aVR have been an independent predictor LM/3VD in patients with ACS. Key words: Acute coronary syndromes, ST-segment elevation, aVR

scholarly journals Prognostic Value of Coronary CT Angiography in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes

2021 ◽  
Vol 77 (8) ◽  
pp. 1044-1052 ◽  
Author(s):  
Klaus F. Kofoed ◽  
Thomas Engstrøm ◽  
Per E. Sigvardsen ◽  
Jesper J. Linde ◽  
Christian Torp-Pedersen ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Acute Coronary Syndromes ◽  
Prognostic Value ◽  
Coronary Ct Angiography ◽  
St Segment Elevation ◽  
Coronary Ct ◽  
St Segment ◽  
Coronary Syndromes
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