Document Detail


Update on the management of acute coronary syndromes.
MedLine Citation:
PMID:  11025346     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
At present there is debate as to whether an invasive or a conservative strategy should form the basis of an optimal management strategy for unstable angina/non-Q wave myocardial infarction (UA/NQMI). However, these approaches are complementary, not necessarily mutually exclusive. On the basis of current evidence, all patients should receive optimized medical therapy, with surgical interventions targeted at high-risk patients, to improve both clinical outcomes and cost effectiveness. While standard antithrombotic combinations have improved short-term outcomes, they do not fully eliminate the risk of recurrent ischemic episodes. The recent introduction of direct thrombin inhibitors, platelet fibrinogen receptor antagonists and low-molecular-weight heparins (LMWHs) has offered an opportunity to develop more aggressive antithrombotic regimens. Enoxaparin, an LMWH, has demonstrated improved efficacy compared with standard heparin in both the acute and chronic phases of UA/NQMI, without an increase in major complications caused by bleeding. Further studies are justified to investigate the potential of combined antithrombotic regimens containing enoxaparin as an alternative to heparin in conservative strategies and as adjuncts to interventional procedures. Recommendations for the management of UA/NQMI should be continually reviewed in response to the impact of novel treatment modalities.
Authors:
M Cohen
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cardiology     Volume:  93     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  2000  
Date Detail:
Created Date:  2000-11-08     Completed Date:  2000-11-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  210-9     Citation Subset:  IM    
Copyright Information:
Copyright 2000 S. Karger AG, Basel
Affiliation:
Hahnemann University Hospital, Philadelphia, PA 19102-1192, USA. marc.cohen@tenethealth.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Anticoagulants / therapeutic use*
Coronary Disease / drug therapy*
Drug Therapy, Combination
Fibrinolytic Agents / therapeutic use*
Humans
Platelet Aggregation Inhibitors / therapeutic use*
Practice Guidelines as Topic
Thrombolytic Therapy / methods*,  standards
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors

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


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