Synonyms
Definition
ACS Definition
Acute coronary syndrome (ACS) is comprised of two related entities: acute myocardial infarction (AMI) and unstable angina. Both entities are caused by an insufficient delivery of oxygen to cardiac myocytes. In myocardial infarction, a sustained disruption in the delivery of substrate leads to cellular death and necrosis. Unstable angina is typically an intermittent or incomplete disruption in cellular substrate delivery that by definition does not cause detectable amounts of cellular death. Unstable angina differs in definition from AMI in that no measurable myocardial necrosis, and therefore no elevated cardiac markers are present.
Risk Stratification
The concept of risk stratification is critical to the evaluation and treatment of ACS. Several levels of risk stratification are commonly used to determine prognosis and to direct treatment. The rationale for risk stratification is matching individual patients with diagnostic and...
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References
Anderson JL, Adams CD, Antman EM et al. ACC/AHA (2007) Guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (writing committee to revise the 2002 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction). Circulation 116(7):e148–304.
Granger CB, Goldberg RJ, Dabbous O et al (2003) Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med 163:2345–2353
Morrow DA, Antman EM, Charlesworth A et al (2000) TIMI risk score for ST-elevation myocardial infarction: a convenient, bedside, clinical score for risk assessment at presentation: an intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation 102:2031–2037
Halkin A, Singh M, Nikolsky E et al (2005) Prediction of mortality after primary percutaneous coronary intervention for acute myocardial infarction: the CADILLAC risk score. J Am Coll Cardiol 45:1397–1405
Antman EM, Cohen M, Bernink PJLM et al (2000) The TIMI risk score for unstable angina/non-st elevation MI: a method for prognostication and therapeutic decision making. J Am Med Assoc 284:835–842
Boersma E, Pieper KS, Steyerberg EW et al (2000) Predictors of outcome in patients with acute coronary syndromes without persistent st-segment elevation: results from an international trial of 9461 patients. Circulation 101:2557–2567
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© 2012 Springer-Verlag Berlin Heidelberg
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Miller, C.D. (2012). Acute Coronary Syndrome: Risk Stratification. In: Vincent, JL., Hall, J.B. (eds) Encyclopedia of Intensive Care Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-00418-6_797
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DOI: https://doi.org/10.1007/978-3-642-00418-6_797
Publisher Name: Springer, Berlin, Heidelberg
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