Document Detail


Current management of unstable angina: lessons from the TACTICS-TIMI 18 trial.
MedLine Citation:
PMID:  14727969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients presenting with unstable angina pectoris or non-Q-wave myocardial infarction (MI), if treated inadequately, are at a high risk of MI and subsequent mortality. The use of intravenous small molecule glycoprotein IIb/IIIa inhibitors along with standard therapeutic management options improves outcome. Since the publication of the Thrombolysis in Myocardial Ischemia IIIB, Veterans Affairs Non-Q-Wave Infarction Strategies In-Hospital (VANQWISH) and Fragmin and Fast Revascularization during InStability in Coronary artery disease II (FRISC II) studies, there is great debate about the advantages of following an early 'invasive' treatment option with coronary angiography and revascularization after initial medical therapy compared with the 'conservative' approach, where angiography is reserved for those who remain symptomatic. The Treat angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy--Thrombolysis in Myocardial Infarction 18 (TACTICS-TIMI 18) study has helped to resolve some of the controversies since it was designed with more current medical (early and routine use of tirofiban) and revascularization (use of stents during percutaneous coronary interventions) options as part of the invasive treatment protocol. This study indicated that an early invasive strategy in risk stratified patients combined with early use of tirofiban with standard medical therapy significantly improves outcome and appears well tolerated.
Authors:
Ganesh Manoharan; A A Jennifer Adgey
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of cardiovascular drugs : drugs, devices, and other interventions     Volume:  2     ISSN:  1175-3277     ISO Abbreviation:  Am J Cardiovasc Drugs     Publication Date:  2002  
Date Detail:
Created Date:  2004-01-19     Completed Date:  2004-04-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100967755     Medline TA:  Am J Cardiovasc Drugs     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  237-43     Citation Subset:  IM    
Affiliation:
Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, Northern Ireland. gmanoharan@msn.com
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / drug therapy,  economics,  therapy*
Angioplasty, Balloon
Aspirin / therapeutic use
Dalteparin / therapeutic use
Drug Therapy, Combination
Fibrinolytic Agents / therapeutic use
Heparin / therapeutic use
Humans
Myocardial Infarction / drug therapy
Myocardial Ischemia / drug therapy,  therapy
Randomized Controlled Trials as Topic
Risk Assessment
Thrombolytic Therapy
Tyrosine / analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Dalteparin; 0/Fibrinolytic Agents; 144494-65-5/tirofiban; 50-78-2/Aspirin; 55520-40-6/Tyrosine; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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