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Unstable angina

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Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Opinion Statement

The recent availability of novel antiplatelet and antithrombin agents has revolutionized the therapeutic options for intermediate- and high-risk unstable angina (UA). Current guidelines recommend aspirin, unfractionated heparin (UFH), and antianginal therapy. Low-molecular-weight heparin (LMWH) and direct thrombin inhibitors have significant theoretical advantages and apparent clinical benefits compared with UFH and are good alternatives in selected patients. Glycoprotein (GP) IIb/IIIa receptor inhibition reduces the future risk of myocardial infarction (MI) and may reduce the incidence of death in patients with unstable angina. In particular, these drugs should be considered for use in combination with aspirin and UFH in patients undergoing an “early invasive” approach. Coronary revascularization plays an important role in high-risk patients and in those with refractory angina, but its routine application continues to be controversial. Issues regarding the use of LMWH in combination with GP IIb/IIIa inhibitors and during percutaneous transluminal coronary angioplasty (PTCA) are being addressed in clinical trials. Ideally, the incidence of serious cardiac events in patients with UA will continue to decrease with the ongoing search for potent drug combinations that achieve early control of intracoronary thrombosis.

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Authors and Affiliations

  1. UMH Medicine, University of Michigan, 3910 TC, 48109, Ann Arbor, MI, USA

    M. Bilal Murad MD

  2. Division of Cardiovascular Medicine, Hennepin County Medical Center, 701 Park Avenue South, 55415, Minneapolis, MN, USA

    Timothy D. Henry MD

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Murad, M.B., Henry, T.D. Unstable angina. Curr Treat Options Cardio Med 2, 37–53 (2000). https://doi.org/10.1007/s11936-000-0027-9

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