Non-ST-elevation myocardial

Acute Pharmacological Management of Unstable Angina and Non-ST Elevation Myocardial Infarction... 

ACC/AHA Practice Guidelines. ACC/AHA 2007 guideline for the management of patients with unstable angina. Non-ST-elevation myocardial infarction executive summary. Circulation 2007 116 803-77. 

Hoenig MR, Doust JA, Aroney CN, Scott lA. Early invasive versus conservative strategies for unstable angina non-ST-elevation myocardial infarction in the stent era. Cochrane Database Syst Rev 2006. Issue 3. 

Glycoprotein llb/llla inhibitors in unstable angina and non-ST elevation myocardial infarction... 

Morrow DA, Cannon CR Rifai N, et al. Ability of minor elevations of troponin I and troponin T to predict benefit from an early invasive strategy in patients with unstable angina and non-ST elevation myocardial infarction. J Am Med Assoc 2001 286 2405-2412. 

Wiviott SD, Cannon CR Morrow DA, et al. Differential expression of cardiac biomarkers by gender in patients with unstable angina/non-ST elevation myocardial infarction. Circulation 2004 109 580-586. 

The acute coronary syndromes (ACS) are now classified on the basis of the ECG and plasma troponin measurements into (1) patients with ST elevation myocardial infarction (STEMI), (2) non-ST elevation myocardial infarction (non-STEMI, by ECG and a positive troponin test) and (3) unstable angina (by ECG and negative troponin test). The present account recognises that this is a rapidly evolving field, but therapeutic strategies are likely to evolve according to these forms of ACS. 

Total loss of coronary blood flow results in a clinical syndrome associated with what is known as ST segment elevation AMI (STE AMI). Partial loss of coronary perfusion if severe also can lead to necrosis as well—which is generally less severe and is loiown as NSTEMI (non-ST-elevation myocardial infarction), and other events of still lesser severity may be missed entirely or called angina, which can range from stable to unstable. 

Figure 44-14 The distinction between non-ST elevation myocardial infarction and unstable angina predicated on an increased cardiac troponin in patients presenting with ischemic discomfort. (Data from Brerinan ML, Penn MS,Viin Lente F, Nambi V, Shishehbor MH, Aviles RJ, etal. Prognostic value of myeloperoxidase in patients with chest pain. N Engl J Med 2003 349 1595-604.)...

Morrow DA, de Lemos JA, Sabatine MS, Murphy SA, Demopoulos LA, DiBattiste PM, et al. Evaluation of B-type natriuretic peptide for risk assessment in unstable angina/non-ST-elevation myocardial infarction B-type natriuretic peptide and prognosis in TACTICS-TIMI 18. Journal of the Am Coll Cardiol 2003 41 1264-72. 

Holper EM, Antman EM, McCabe CH et al. A simple, readily available method for risk stratification of patient with unstable angina and non-ST elevation myocardial infarction. Am J Cardiol 2001 87 1008. 

Fox KAA, Poole-Wilson PA, Henderson RA, et al. Interventional versus conservative treatment for patients widi unstable angina or non-ST-elevation myocardial infarction The British Heart Foundation RITA 3 randomised trial. Lancet 2002 360 743—751. 

Cannon CP, Weintraub WS, Demopoulos L A, et at. Comparison of early invasive versus early conservative strategies in patients with unstable angina and non-ST elevation myocardial infarction treated with early glycoprotein Ilb/IIIa inhibition. N Engl J Med 2001 344(25) 1879-87. 

Anderson JL, Adams CD, Antman EM, et al. ACC/AHA2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction. JACC 2007 50(7) el-157. 

Krumholz HM, Anderson JL, Bachelder BL, et al. ACC/AHA 2008 performance measures for adults with ST-elevation and non-ST-elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Performance Measures./ Am Coll Cardiol 2008 52(24)2046-99. 

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