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Advances in the pathogenesis and treatment of acute coronary syndromes

C A Thompson1, J D Danzell, H G Hanley

  • 1Department of Internal Medicine, Louisiana State University School of Medicine, Shreveport, USA.

The Journal of the Louisiana State Medical Society : Official Organ of the Louisiana State Medical Society
|June 11, 1999
PubMed

Insights

Acute coronary syndromes, including unstable angina and myocardial infarction, require prompt treatment. While reperfusion is key for ST elevation myocardial infarction, newer therapies like enoxaparin show promise for other acute coronary syndromes.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Unstable angina, non-Q wave myocardial infarction, and Q wave myocardial infarction are linked by shared pathogenesis under acute coronary syndromes.
  • Prompt reperfusion via thrombolysis or percutaneous transluminal coronary angioplasty is established for acute ST segment elevation myocardial infarction.

Purpose of the Study:

  • To review the established and emerging treatments for acute coronary syndromes.
  • To highlight advances in managing unstable angina and non-Q wave myocardial infarction.

Main Methods:

  • Review of current therapeutic strategies for acute coronary syndromes.
  • Evaluation of the efficacy and potential harms of different treatment modalities.

Main Results:

  • Thrombolysis may be disappointing or harmful in unstable angina and non-Q wave myocardial infarction.
  • Traditional therapies (morphine, oxygen, nitrates, aspirin, heparin, beta blockers) are indicated for all acute coronary syndromes.
  • Enoxaparin and platelet glycoprotein IIb/IIIa receptor antagonists show particular effectiveness in unstable angina/non-Q wave myocardial infarction.

Conclusions:

  • Treatment strategies for acute coronary syndromes vary based on specific clinical entities.
  • Enoxaparin and glycoprotein IIb/IIIa inhibitors represent significant advances for unstable angina and non-Q wave myocardial infarction management.

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