Acute coronary syndromes

In the UK, there are over 80,000 admissions annually with acute coronary syndromes (ACS). Management of ST-elevation myocardial infarction (STEMI) involves primary percutaneous coronary intervention (PCI), which is delivered via dedicated heart attack centres. Non-ST elevation-ACS (NSTE-ACS) account...

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Bibliographic Details
Published in:Clinical medicine (London, England) England), 2016-12, Vol.16 (6), p.s43-s48
Main Authors: Kotecha, Tushar, Rakhit, Roby D
Format: Article
Language:English
Subjects:
Acute coronary syndrome
Acute coronary syndromes
Heart attacks
Medical imaging
Mortality
non-ST elevation acute coronary syndrome
non-ST elevation ­myocardial infarction
ST-elevation myocardial infarction
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Summary:In the UK, there are over 80,000 admissions annually with acute coronary syndromes (ACS). Management of ST-elevation myocardial infarction (STEMI) involves primary percutaneous coronary intervention (PCI), which is delivered via dedicated heart attack centres. Non-ST elevation-ACS (NSTE-ACS) accounts for two-thirds of ACS presentations, affecting an older cohort of patients – often with more complex comorbidities. Initial management is with anti-thrombotic therapy with a view to PCI within 24 hours for the most acute cases and within 72 hours for all others. However, varying management pathways and access to specialist cardiology services results in variable times to definitive treatment. Advances in the sensitivity of cardiac biomarkers and the use of risk assessment tools now enable rapid diagnosis within a few hours of symptom onset. Advances in invasive management and drug therapy have resulted in improved clinical outcomes with resultant decline in mortality associated with ACS.
ISSN:1470-2118
1473-4893
DOI:10.7861/clinmedicine.16-6-s43