Antiplatelet therapy in acute coronary syndromes: implications for nursing practice

The care of cardiovascular patients experiencing a myocardial infarction (MI) has evolved from simple bed rest and relief of pain to complex interventions and multiple medications that target both the short- and long-term risks associated with atherosclerosis and ischemia. Even the terminology has changed, from MI to acute coronary syndromes (ACSs). The term, acute coronary syndrome, refers to the clinical symptoms resulting from acute myocardial ischemia; it encompasses unstable angina, non-ST-elevation MI, and ST-elevation MI. Antiplatelet therapies are critically important in the management of patients with ACS. Antiplatelet therapies interfere with platelet aggregation and platelet activation both acutely and chronically and thus impact the development of acute MI. Thus, they are prescribed for millions of patients with ACS. As a result of this progress in treatment, nursing management of persons with ACS has also evolved. This article reviews the pathophysiology of ACS, the role of antiplatelet therapies, their effects on platelet adhesion, and the role of the nurse in caring for patients with ACS who are prescribed these important therapies.