Newer concepts in the treatment of unstable angina pectoris

Unstable angina patients should be hospitalized and treated with antianginal drugs to control their symptoms and with aspirin or heparin to reduce the risk of myocardial infarction. Heparin is probably preferable to aspirin acutely, because it also reduces the risk of refractory angina. However, aspirin therapy should be started before heparin is discontinued, to prevent the rebound in symptoms, and continued long-term. Unless specifically contraindicated, coronary arteriography should be performed to identify patients who might benefit from coronary bypass surgery or angioplasty. Control of risk factors is important for long-term outcome.