Symptoms And Treatment Of Acute Coronary Syndrome

1627 Words Feb 1st, 2016 7 Pages
Introduction Acute coronary syndrome (ACS) refers to a group of conditions with clinical symptoms similar to acute myocardial ischemia, including pressure-like chest pain associated with nausea and sweating (1). It includes non-ST segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction (STEMI), and unstable angina (UA).

ACS patients are at increased risk of myocardial infarction and death, therefore, the moderate- to high-risk patients with ACS are treated with early cardiac catheterization followed by prompt revascularization (1,2). In order to prevent peri-procedural thrombotic problems during the percutaneous coronary intervention (PCI) anticoagulation is required (3). Anticoagulation remains the core of treatment in patients with ACS. The most frequent anticoagulation used during early phase of ACS and PCI is low molecular weight heparins (LMWHs) and unfractionated heparin (UFH) (3). The combination of antithrombotic and antiplatelet agents are efficient in containing ischemic events in relation to PCI, but have been noted to have higher rates of bleeding complications (4-10). Bivalirudin has shown to have a better safety profile when compared with heparin along with glycoprotein IIb/IIIa (GP) administration (11). Bivalirudin for this reason is considered the anticoagulant of choice in patients with ACS. Bivalirudin is a direct thrombin inhibitor (DTI) that is effective against clot-bound thrombin, unlike UFH and LMWHs (12).…
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