[Risk stratification in acute coronary syndrome].
نویسندگان
چکیده
BACKGROUND The spectrum of symptoms of patients with active ischemic heart disease ranges from silent ischemia to acute myocardial infarction and the extent of myocardial damage from reversible myocardial injury to extensive necrosis. The term "acute coronary syndrome" comprises this continuum. In particular the evaluation of patients without ST-segment elevation is difficult, for clinical symptoms, ECG criteria and CK-MB measurements appear insufficient for appropriate risk stratification. TROPONIN MEASUREMENT Serial measurements of either troponin T or I reliably detect minor myocardial damage in those patients, who are known to be at a higher risk for adverse cardiac events comparable to the risk of patients with acute myocardial infarction. Hence determination of troponins allow superior risk stratification contributing to early triage and therapeutic decision making. Without elevation of troponins the cardiac risk for death or myocardial infarction will not exceed 1%. CONCLUSION Patients with elevated troponins should be early hospitalized and further evaluated in order to begin efficacious therapy as soon as possible. These patients represent a high-risk subgroup of patients clinically classified as unstable angina, who might benefit from potential antithrombotic treatment such as low-molecular weight heparin or glycoprotein IIb/IIIa antagonists without or with revascularization strategies.
منابع مشابه
Impact of Age on Risk Factors and Clinical Manifestations of Acute Coronary Syndrome: Observations From the Coronary Care Unit of Sulaimani, Iraq
Background: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI ) are common types of acute coronary syndrome which are associated with the risk factors of age, obesity, hypertension, and diabetes. Objective: The present study aimed to examine the effects of age on the risk factors and clinical sym...
متن کاملThe Effect of Two Different Doses of Atorvastatin on Lipoprotein-A on Patients with Acute Coronary Syndrome
Background and Objectives: Lipoprotein-a potentially represents a useful tool for risk stratification in cardiovascular accidents. The aim of this study was to evaluate the atorvastatin effect on serum lipid profile & lipoprotein A. Material & Methods: In 2009, 405 patients with acute coronary syndrome randomly were divided into 2 groups, taking 20 & 40 mg atorvastatin daily for 3 months. Lip...
متن کاملAcute coronary syndromes: risk stratification and initial management.
For patients who have acute coronary syndromes (ACS), risk stratification is key to initiating appropriate treatment. For ST-segment elevation MI, immediate reperfusion therapy is needed, and thus rapid identification of ST elevation on the ECG is critical. Then, having a standardized protocol for rapid treatment- with either primary percutaneous coronary intervention or thrombolysis - is criti...
متن کاملThe association between neck circumference and cardiovascular risk factors in patients with acute coronary syndrome
Purpose: To investigate the relationship between neck circumferences and cardiovascular risk factors in patients with acute coronary syndrome. Materials and Methods: In a cross-sectional study, 100 patients with acute coronary syndrome in Kerman hospitals were assessed by measuring their neck circumference and risk factors of cardiovascular disease. The data were analyzed by student t...
متن کاملThe role of biomarkers in the diagnosis and risk stratification of acute coronary syndrome
Coronary artery disease is a growing concern. Although traditional biomarkers, such as troponins and creatine kinase, play a central role in the diagnosis, risk stratification and management of coronary artery disease, they are unable to detect myocardial ischemia in the absence of necrosis. Therefore, early detection of ischemia in patients presenting with acute coronary syndrome still remains...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Herz
دوره 26 Suppl 1 شماره
صفحات -
تاریخ انتشار 2001