Ciffone Nicole, Dokken Betsy B
Arizona Center for Advanced Lipidology, Tucson, Arizona.
Tandem Diabetes Care, Inc., San Diego, California.
J Am Assoc Nurse Pract. 2017 Apr;29(4):224-235. doi: 10.1002/2327-6924.12457.
Recent updates to clinical guidelines and pharmacological indications have added to the complexity of acute coronary syndrome (ACS) management. Advanced practice nurses working with ACS patients need clear and up-to-date information to optimize patient care.
To provide a practical overview of the management of ACS from patient presentation through to long-term secondary prevention based on recent guidelines and randomized controlled trials, with particular emphasis on medical management.
Systematically reviewed recent studies and guidelines published 2011-2015 using PubMed search terms including "ACS management," "ACS hospital care," and "ACS secondary prevention."
The last decade has seen an increase in the number of antithrombotic (anticoagulant and antiplatelet) agents and an expansion of their licensed indications for treatment of ACS patients. Future trials will help identify which subgroups of patients will gain the greatest benefit from more intense antithrombotic therapy.
Management of ACS is dependent on individual patient characteristics and risk stratification. Greater choice among therapies available for acute and long-term management will help to achieve optimal, patient-tailored care.
临床指南和药理学指征的最新更新增加了急性冠状动脉综合征（ACS）管理的复杂性。护理ACS患者的高级执业护士需要清晰且最新的信息来优化患者护理。
基于近期指南和随机对照试验，提供从患者就诊到长期二级预防的ACS管理实用概述，尤其侧重于药物治疗管理。
使用包括“ACS管理”“ACS住院治疗”和“ACS二级预防”等在内的PubMed搜索词，系统回顾2011 - 2015年发表的近期研究和指南。
过去十年，抗血栓形成（抗凝和抗血小板）药物数量增加，其治疗ACS患者的许可指征范围扩大。未来试验将有助于确定哪些患者亚组将从更强化的抗血栓形成治疗中获得最大益处。
ACS的管理取决于个体患者特征和风险分层。急性和长期管理中更多治疗选择将有助于实现优化的、针对患者的护理。
