| Antiplatelet therapy in early management of non-ST-segment elevation acute coronary syndrome: the 2002 and 2007 guidelines from North America and Europe. | |
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MedLine Citation:
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PMID: 18418272 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The American College of Cardiology, American Heart Association, and the European Society of Cardiology published updated guidelines in 2007 for patients with non-ST elevation acute coronary syndrome. In this article, we review the recommendations for antiplatelet therapy and supporting data, highlight new changes, and describe differences between the European and North American guidelines. The new guidelines provide more details regarding the selection of an early conservative versus an early invasive approach based on the patient's profile and balance between ischemic and bleeding risks. Important new recommendations include wider endorsement for low-dose aspirin maintenance therapy, longer duration of clopidogrel following percutaneous coronary intervention, additional guidance regarding surgery in selected patients on clopidogrel, identification of patients most likely to benefit from glycoprotein IIb/IIIa inhibitors (with appropriate dose modification in patients with renal failure), and the option to use early clopidogrel with bivalirudin in patients managed invasively who are at increased risk of bleeding. The new guidelines also discourage the concomitant use of nonsteroidal anti-inflammatory drugs and delineate indications for adding warfarin to antiplatelet therapy. Because antiplatelet therapy is the cornerstone of management of patients with non-ST elevation acute coronary syndrome, health care providers should make themselves familiar with the new data and latest guideline recommendations. |
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Authors:
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Deepak Thomas; Robert P Giugliano |
Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Journal of cardiovascular pharmacology Volume: 51 ISSN: 0160-2446 ISO Abbreviation: J. Cardiovasc. Pharmacol. Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-05-22 Completed Date: 2008-11-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7902492 Medline TA: J Cardiovasc Pharmacol Country: United States |
Other Details:
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Languages: eng Pagination: 425-33 Citation Subset: IM |
Affiliation:
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Department of Nuclear Cardiology, Brigham & Women's Hospital, Boston, MA, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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drug therapy* Anti-Inflammatory Agents, Non-Steroidal / contraindications Aspirin / administration & dosage, therapeutic use Europe Humans North America Platelet Aggregation Inhibitors / administration & dosage, therapeutic use* Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors Practice Guidelines as Topic* Ticlopidine / administration & dosage, analogs & derivatives, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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