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Revascularization Strategies for Non-ST-Elevation Myocardial Infarction

  • Management of Acute Coronary Syndromes (H Jneid, Section Editor)
  • Published:
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Abstract

Purpose of Review

Non-ST-elevation myocardial infarction (NSTEMI) is an urgent medical condition that requires prompt application of simultaneous pharmacologic and non-pharmacologic therapies. The variation in patient clinical characteristics coupled with the multitude of treatment modalities makes optimal and timely management challenging. This review summarizes risk stratification of patients, the role and timing of revascularization, and highlights important considerations in the revascularization approach with attention to individual patient characteristics.

Recent Findings

The early invasive management of NSTEMI has fostered a reduction in future ischemic events. Risk calculators are helpful in determining which patients should receive early invasive management. As many patients have multivessel disease, identifying the true culprit lesion can be challenging. Special attention should be given to those at the highest risk, such as diabetics, patients with renal failure, and those with left main disease.

Summary

In patients with acute coronary syndrome, the decision and mode of revascularization should carefully integrate the patient’s clinical characteristics as well as the complexity of the coronary anatomy.

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  1. Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, 900 S. Limestone Street, 326 Wethington Bldg, Lexington, KY, 40536-0200, USA

    Bennet George, Naoki Misumida & Khaled M. Ziada

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George, B., Misumida, N. & Ziada, K.M. Revascularization Strategies for Non-ST-Elevation Myocardial Infarction. Curr Cardiol Rep 21, 39 (2019). https://doi.org/10.1007/s11886-019-1125-9

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