A review of the acute management of unstable angina and NSTEMI, highlighting the role of antiplatelet and anticoagulation agents in reducing ischemic pain and myocardial damage.
May guide acute NSTEMI decisions; leaves open optimal regimens in evolving practice.
Non-ST segment elevation coronary syndrome usually results from instability of an atherosclerotic plaque, with subsequent activation of platelets and several coagulation factors. Its treatment aims to reduce the ischemic pain, limiting myocardial damage and decreasing mortality. Several antiplatelet and anticoagulation agents have been proven useful, and new drugs have been added to the therapeutic armamentarium in the search for higher anti-ischemic efficacy and lower bleeding rates. Despite the advances, the mortality, infarction and readmission rates remain high.
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Morita et al. (2015) studied this question.
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