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Overview of 2003 Updates to the
ACC/AHA Guideline for UA/NSTEMI
Assess likelihood of CAD
Risk stratification
Target therapy: more aggressive treatment in
higher-risk patients
Anti-ischemic, antithrombotic therapy
Invasive vs conservative strategy
Discharge planning (risk factor modification and
long-term medical therapy)
ACC/AHA, American College of Cardiology/American Heart Association; UA, unstable angina;
NSTEMI, non–ST-segment elevation myocardial infarction.
Braunwald E, et al. J Am Col. Cardiol. 2000;36:970-1062.
Acute Management of UA/NSTEMI
Anti-Ischemic Therapy
Oxygen, bed rest, ECG monitoring
Nitroglycerin
?-Blockers
ACE inhibitors
Antithrombotic Therapy
Antiplatelet therapy
Anticoagulant therapy
UA, unstable angina; NSTEMI, non-ST-segment elevation myocardial infarction; ECG, electrocardiogram; ACE, angiotensin-converting enzyme.
Braunwald E, et al. J Am Coll Cardiol. 2000;36:970-1062.
TIMI IIB/ESSENCE Metanalysis:
Enoxaparin vs Unfractionated Heparin
TIMI, Thrombosis in Myocardial Infarction; ESSENCE, Efficacy and Safety of Subcutaneous Enozapam in Non–Q-Wave Coronary Events; UHF, unfractionated heparin; ENOX, enoxaparin; MI, myocardial infarction; OR, odds ratio.
Antman EM, et al. Circulation. 1999;100:1602-1608. (with permission)
TIMI IIB: Early Phase
Death/MI/Urgent Revasc
UHF, unfractionated heparin; ENOX, enoxaparin; RRR, relative risk ratio.
Antman EM. Circulation. 1999;100:1593-1601. (with permission)
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