![]() ![]() The heparin is to be used in addition to aspirin or clopidogrel. These agents should be administered in addition to aspirin and heparin.Īnticoagulation with unfractionated heparin or low-molecular-weight heparin for patients with UA/NSTEMI has an ACC/AHA class I indication. Platelet glycoprotein IIb/IIIa inhibitors have an ACC/AHA class I indication in patients for whom catheterization and percutaneous coronary intervention are planned. When elective coronary artery bypass grafting is planned, clopidogrel should be withheld for five to seven days. The updated ACC/AHA guideline considers the use of clopidogrel in addition to aspirin to have a class I indication in patients with UA/NSTEMI who are undergoing an early noninterventional or interventional approach and are not at high risk for bleeding. The updated ACC/AHA guideline recommends use of the thienopyridine clopidogrel (Plavix) in patients who cannot tolerate aspirin (ACC/AHA class I). Medical treatment includes anti-ischemic therapy (oxygen, nitroglycerin, beta blocker), antiplatelet therapy (aspirin, clopidogrel, platelet glycoprotein IIb/IIIa inhibitor), and antithrombotic therapy (heparin, low-molecular-weight heparin). The Thrombolysis in Myocardial Infarction (TIMI) risk score is a simple method that was initially derived from fibrinolytic-treated patients with STEMI to. Hospital care consists of appropriate initial triage and monitoring. During the initial evaluation, the history, physical examination, electrocardiogram, and cardiac biomarkers are used to determine the likelihood that the patient has UA/NSTEMI and to aid in risk assessment when the diagnosis is established. Part I of this two-part article discusses the first two components of management. Management of suspected UA/NSTEMI has four components: initial evaluation and management hospital care coronary revascularization and hospital discharge and post-hospital care. This guideline, which was published in 2000 and updated in 2002, highlights recent medical advances and is a practical tool to help physicians provide medical care for patients with UA/NSTEMI. To help standardize the assessment and treatment of these patients, the American College of Cardiology and the American Heart Association convened a task force to formulate a management guideline. hospitals because of unstable angina and non–ST-segment elevation myocardial infarction (UA/NSTEMI). New variables were major clinical events occurring during the index hospitalization. Baseline variables were from the original TIMI risk score for STEMI. Each year, more than 1 million patients are admitted to U.S. Methods and results: The dynamic TIMI risk score for STEMI was derived in ExTRACT-TIMI 25 and validated in TRITON-TIMI 38. ![]()
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