Escabí-Mendoza José, Rosales-Alvarez Claudia
Cardiology Section, Department of Medicine, Veterans Administration Medical Center of San Juan, Puerto Rico.
P R Health Sci J. 2005 Dec;24(4):323-36.
Patients hospitalized with unstable angina (UA) or with a non-ST segment elevation myocardial infarct (NSTEMI) are at increased risk of suffering refractory angina, recurrent myocardial infarct (MI), and death. These patients need to be evaluated more aggressively. According to the last published guidelines (2002) of UA/NSTEMI by the ACC/AHA Task Force, these patients should be categorized in a risk scale as: low, intermediate or high. This should be done in the initial evaluation, which includes: medical history, physical exam, an electrocardiogram (ECG) and cardiac markers. The TIMI risk score should also be used as complementary in this risk assessment. High risk patients, without contraindications, should be managed more aggressively with coronary angiography. On the other end, low risk patients, and some intermediate, may be evaluated more conservatively with early non-invasive studies for further assessment of ischemia and prognosis.
因不稳定型心绞痛（UA）或非ST段抬高型心肌梗死（NSTEMI）住院的患者发生难治性心绞痛、复发性心肌梗死（MI）及死亡的风险增加。这些患者需要更积极地进行评估。根据美国心脏病学会/美国心脏协会（ACC/AHA）工作组最近发布的UA/NSTEMI指南（2002年），这些患者应按风险程度分为：低、中或高风险。这应在初始评估时完成，初始评估包括：病史、体格检查、心电图（ECG）及心脏标志物检查。在该风险评估中，TIMI风险评分也应作为补充使用。无禁忌证的高风险患者应更积极地接受冠状动脉造影检查。另一方面，低风险患者以及部分中风险患者，可通过早期非侵入性检查进行更保守的评估，以进一步评估缺血情况及预后。
