Díez-Villanueva Pablo, Jiménez-Méndez César, Cepas-Guillén Pedro, Arenas-Loriente Andrea, Fernández-Herrero Ignacio, García-Pardo Héctor, Díez-Delhoyo Felipe
Cardiology Department, Hospital Universitario La Princesa, 28006 Madrid, Spain.
Cardiology Department, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain.
Biomedicines. 2024 Aug 2;12(8):1736. doi: 10.3390/biomedicines12081736.
Cardiovascular disease constitutes the leading cause of morbimortality worldwide. Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) is a common cardiovascular condition, closely related to the ageing population and significantly affecting survival and quality of life. The management of NSTE-ACS requires specific diagnosis and therapeutic strategies, thus highlighting the importance of a personalized approach, including tailored antithrombotic therapies and regimens, combined with timely invasive management. Moreover, specific and frequent populations in clinical practice, such as the elderly and those with chronic kidney disease, pose unique challenges in the management of NSTE-ACS due to their increased risk of ischemic and hemorrhagic complications. In this scenario, comprehensive management strategies and multidisciplinary care are of great importance. Cardiac rehabilitation and optimal management of cardiovascular risk factors are essential elements of secondary prevention since they significantly improve prognosis. This review highlights the need for a personalized approach in the management of NSTE-ACS, especially in vulnerable populations, and emphasizes the importance of precise antithrombotic management together with tailored revascularization strategies, as well as the role of cardiac rehabilitation in NSTE-ACS patients.
心血管疾病是全球发病和死亡的主要原因。非ST段抬高型急性冠状动脉综合征(NSTE-ACS)是一种常见的心血管疾病,与人口老龄化密切相关,对生存和生活质量有重大影响。NSTE-ACS的管理需要特定的诊断和治疗策略,因此凸显了个性化方法的重要性,包括量身定制的抗栓治疗和方案,并结合及时的侵入性管理。此外,临床实践中的特定和常见人群,如老年人和慢性肾病患者,由于其缺血和出血并发症风险增加,在NSTE-ACS的管理中面临独特挑战。在这种情况下,综合管理策略和多学科护理非常重要。心脏康复和心血管危险因素的优化管理是二级预防的关键要素,因为它们能显著改善预后。本综述强调了在NSTE-ACS管理中采用个性化方法的必要性,特别是在脆弱人群中,并强调了精确抗栓管理与量身定制的血运重建策略的重要性,以及心脏康复在NSTE-ACS患者中的作用。