PMID- 19214407
OWN - NLM
STAT- MEDLINE
DCOM- 20090326
LR  - 20211020
IS  - 1615-6692 (Electronic)
IS  - 0340-9937 (Linking)
VI  - 34
IP  - 1
DP  - 2009 Feb
TI  - [Acute coronary syndromes without ST segment elevation].
PG  - 30-8
LID - 10.1007/s00059-009-3194-9 [doi]
AB  - Coronary artery disease accounts for most deaths in Western communities. 
      Especially acute coronary syndromes--with or without ST segment elevation in the 
      ECG--are potentially life-threatening events. The tremendous number of more than 
      400,000 acute coronary syndromes per year in Germany demonstrates the necessity 
      of guidelines for diagnosis and treatment approaches. During the diagnostic 
      process the patients' individual risk is repeatedly assessed. The ultimate 
      treatment regimen is based on this risk stratification and includes five major 
      therapeutic tools: anti-ischemic agents, anticoagulants, antiplatelet drugs, 
      coronary revascularization, and long-term patient management. Several 
      anticoagulants, which act at different levels of the coagulation cascade, have 
      been investigated in the NSTE-ACS (non-ST elevation acute coronary syndrome). 
      Most anticoagulants have been shown to be capable of reducing the risk of death 
      and myocardial infarction, however, at the cost of bleeding complications. 
      Antiplatelet agents are necessary for both, the acute event and the subsequent 
      maintenance therapy. The recommended treatment regimen includes aspirin in 
      combination with a thienopyridine. During the acute phase of the acute coronary 
      syndrome, glycoprotein IIb/IIIa inhibitors have been shown to reduce 
      cardiovascular events. Revascularization for NSTE-ACS is performed to relieve 
      angina and ongoing myocardial ischemia, and to prevent the progression to 
      myocardial infarction or death. The indications for myocardial revascularization 
      and the preferred approach (percutaneous coronary intervention or coronary artery 
      bypass grafting) depend on the extent and severity of the lesions as identified 
      by coronary angiography, the patient's condition and comorbidity. The long-term 
      management after an acute coronary syndrome implies lifestyle measures and drug 
      treatment in order to control risk factors impacting on the patients' outcome.
FAU - Mollmann, Helge
AU  - Mollmann H
AD  - Kerckhoff-Klinik, Benekestrasse 2-8, 61231, Bad Nauheim. 
      h.moellmann@kerckhoff-klinik.de
FAU - Nef, Holger
AU  - Nef H
FAU - Hamm, Christian W
AU  - Hamm CW
LA  - ger
PT  - English Abstract
PT  - Journal Article
TT  - Das akute Koronarsyndrom ohne ST-Hebung.
PL  - Germany
TA  - Herz
JT  - Herz
JID - 7801231
SB  - IM
MH  - Acute Coronary Syndrome/*diagnosis/*prevention & control
MH  - Cardiology/*standards
MH  - Germany
MH  - Humans
MH  - *Practice Guidelines as Topic
MH  - Practice Patterns, Physicians'/standards
MH  - Preventive Medicine/*standards
EDAT- 2009/02/14 09:00
MHDA- 2009/03/27 09:00
CRDT- 2009/02/14 09:00
PHST- 2009/02/14 09:00 [entrez]
PHST- 2009/02/14 09:00 [pubmed]
PHST- 2009/03/27 09:00 [medline]
AID - 10.1007/s00059-009-3194-9 [doi]
PST - ppublish
SO  - Herz. 2009 Feb;34(1):30-8. doi: 10.1007/s00059-009-3194-9.