Mukherjee Debabrata, Eagle Kim A
Division of Cardiology, University of Michigan Health System, 3910 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48103, USA.
Curr Cardiol Rep. 2003 Jul;5(4):289-95. doi: 10.1007/s11886-003-0065-5.
Unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) refer to a spectrum of acute severe cardiac disorders characterized by myocardial oxygen demand and supply mismatch, caused by atherosclerotic coronary artery disease. Patients presenting with acute coronary syndromes represent a major medical problem, accounting for 2.5 million hospitalizations and 500000 deaths annually in the United States alone. Of these, 1.5 million have a final diagnosis of UA, and myocardial infarction (ST-segment and non-ST-segment elevation) accounts for the remaining 1 million. The management of UA/NSTEMI presents a challenge to the cardiologist because treatment strategies continue to evolve. A number of trials have now assessed the safety and efficacy of early revascularization strategies in the treatment of patients with UA/NSTEMI, whereas others have focused on pharmacologic adjunctive therapy. An optimal single strategy encompassing most patients' needs is not clear. This review focuses on the revised American College of Cardiology/American Heart Association guidelines for the management of patients presenting with UA/NSTEMI.
不稳定型心绞痛（UA）和非ST段抬高型心肌梗死（NSTEMI）指的是一系列急性重症心脏疾病，其特征为心肌需氧量与供氧量不匹配，由动脉粥样硬化性冠状动脉疾病引起。出现急性冠状动脉综合征的患者构成了一个重大的医学问题，仅在美国每年就有250万例住院病例和50万例死亡。其中，150万最终诊断为UA，心肌梗死（ST段和非ST段抬高型）占其余的100万例。UA/NSTEMI的管理对心脏病专家构成了挑战，因为治疗策略仍在不断发展。现在有多项试验评估了早期血运重建策略在治疗UA/NSTEMI患者中的安全性和有效性，而其他试验则专注于药物辅助治疗。一种涵盖大多数患者需求的最佳单一策略尚不清楚。本综述重点关注美国心脏病学会/美国心脏协会关于UA/NSTEMI患者管理的修订指南。
