Management of unstable angina and non-ST-segment elevation myocardial infarction

Most of the patients with acute coronary syndromes present with unstable angina or non-ST-segment elevation myocardial infarction. Recent advances in the diagnosis and treatment of these conditions have changed the management guidelines, allowing for better patient care. The purpose of this review is to summarize the current knowledge and present both established and new or evolving strategies used in the treatment of patients with unstable angina and non-ST-segment elevation myocardial infarction. Use of aspirin, nitrates, beta-blockers, calcium channel blockers, and anticoagulation with unfractionated heparin has been a common practice in these patients. While still effective and recommended, the emergence of new anticoagulants (low molecular weight heparins) and antiplatelet agents (ADP inhibitors and glycoprotein IIb/IIIa blockers) has added significant benefit to the treatment options and has resulted in a better prognosis for the patients. It also appears that, in view of recent trials, an early invasive approach is becoming the standard of care, especially for high-risk patients.