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Acute Coronary Syndromes: Diagnosis and Management, Part II
Mayo Clinic Proceedings, 11/02/09

Kumar A et al. – At the most severe end of the spectrum of acute coronary syndromes is ST–segment elevation myocardial infarction (STEMI), which usually occurs when a fibrin–rich thrombus completely occludes an epicardial coronary artery. The diagnosis of STEMI is based on clinical characteristics and persistent ST–segment elevation as demonstrated by 12–lead electrocardiography. Patients with STEMI should undergo rapid assessment for reperfusion therapy, and a reperfusion strategy should be implemented promptly after the patient's contact with the health care system. Two methods are currently available for establishing timely coronary reperfusion: primary percutaneous coronary intervention and fibrinolytic therapy. Percutaneous coronary intervention is the preferred method but is not always available. Antiplatelet agents and anticoagulants are critical adjuncts to reperfusion. This article summarizes the current evidence–based guidelines for the diagnosis and management of STEMI. This summary is followed by a brief discussion of the role of noninvasive stress testing in the assessment of patients with acute coronary syndrome and their selection for coronary revascularization.

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Activated factor XII type A and B-type natriuretic peptide are complementary and incremental predictors of mortality in patients following admission with acute coronary syndrome
Blood Coagulation & Fibrinolysis, 11/03/09 Relevance Score: 83%

Endogenous tissue plasminogen activator and risk of recurrent cardiac events after an acute coronary syndrome in the MIRACL study
Atherosclerosis, 10/13/09 Relevance Score: 83%

Effects of Nordic Walking training on exercise capacity and fitness in men participating in early, short-term inpatient cardiac rehabilitation after an acute coronary syndrome — a controlled trial
Clinical Rehabilitation, 11/12/09 Relevance Score: 82%

Management of acute coronary syndrome in a case of Behcets disease
Blood Coagulation & Fibrinolysis, 11/03/09 Relevance Score: 82%

Acute medical management of the non-ST-segment elevation acute coronary syndromes (NSTE-ACS) in older patients
Archives of Gerontology and Geriatrics, 10/14/09 Relevance Score: 82%