, Volume 19, Issue 6, pp 409-420
Date: 17 Sep 2012

Antithrombotic Therapy in Non-ST-Segment Elevation Acute Coronary Syndromes

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Abstract

Background: Unstable angina and non-Q-wave acute myocardial infarction (AMI) are the most frequent causes of admission to the intensive care unit. Despite conventional therapy, the rates of nonfatal AMI and death within 30 days of the episode are 10% and 13%, respectively. The limitations of conventional antithrombotic agents have stimulated research on, and clinical trials of, new therapeutic options. This obliges clinicians to update their knowledge constantly in order to be able to choose the best treatment for this group of patients.

Objective: To develop an updated set of recommendations on current antithrombotic treatments for acute coronary syndromes not involving ST-segment elevation.

Methods: The Rio de la Plata Expert Panel met in July 1999. The work was carried out by three Commissions: (i) stratification of risk; (ii) antithrombotic therapy in the intensive care unit; and (iii) antithrombotic therapy in the cardiac catheterisation laboratory.

Results: The first Commission established the clinical basis for using antithrombotic therapy, and the second and third Commissions prepared recommendations for therapy in the intensive care and haemodynamics units, and for the use of diagnostic coronary angiography.

Conclusions: The members of the Rio de la Plata Expert Panel hope that this document will serve as a useful guide to professional medical practice in the treatment of unstable angina and non-Q-wave coronary syndromes.