Thrombolytics and Invasive vs Conservative Strategies in Unstable Angina

摘要: Acute coronary syndromes represent a clinical spectrum that extends all the way from unstable angina presenting with transient episode of chest pain, to non-ST-elevation myocardial infarction (MI) more prolonged pain and biochemical evidence MI, ST-elevation MI extensive damage formation Q waves on surface electrocardiogram (ECG), finally sudden cardiac death. Pathophysiologic correlations include minor plaque ulceration thrombus in angina, thrombosis non-Q wave complete occlusion Despite initially promising small studies, large randomized trial showed thrombolytic therapy is not beneficial may even be harmful MI. Several trials have compared conservative vs early invasive strategies Results these were conflicting, most antedated use platelet glycoprotein (GP) IIb/IIIa receptor inhibitors stenting. Risk stratification models, based simple laboratory parameters, potentially might allow identification high risk patients who will benefit an approach those lower risk, which management appropriate.