Journal Mobile

KJ Hogg, A Docherty
Journal Issue: 
Volume 36: Issue 2: 2006




The term ‘acute coronary syndrome’ encompasses STEMI, NSTEMI, and UA.  The  electrocardiogram  identifies  those  with  STEMI.  An  elevated  troponin level measured at least 12 hours after the onset of pain distinguishes NSTEMI from UA.  However, the  separation  of  NSTEMI  and  UA  is  somewhat  artificial, as  the management of individual patients is based on their risk score, with troponin being only a small part of the equation.  Patients at moderate to high risk of death, MI, or  subsequent  admission  to  hospital  should  be  offered  early  coronary arteriography  with  a  view  to  revascularisation.   The  CLARITY  and  COMMIT studies, when added to the CURE study, support the early use of clopidogrel in all patients with ACS, irrespective of age