Acute coronary syndrome-the latest updates for unstable angina
The basic pathology for the acute coronary syndrome is similar. However, the damage of the cardiac tissue is one of the most important things that are making the different categories in it. Hence, when it comes to the unstable angina, differentiating it from the non ST segment elevation MI is very important. Most of the time when the patient is showing up with the classical symptoms of angina then with the routine treatment with the sublingual nitroglycerine will not do any good. Hence, it will rule out that the patient is having either unstable angina or MI.
In the emergency setup, the gold standard treatment for such patients is doing ECG. When the patient is suffering from the heart attack, there will be certain changes, which will indicate that either the patient is having the stable angina, unstable angina or acute myocardial infarction. ECG will show the ST segment elevation and the T wave flattening or inversion, but in some cases of unstable angina, there will be no such waves present, and in this way, differentiating between these are difficult as it totally changes the protocols for treatment.
Several trials are done by American heart association and American College of Cardiology and through it; new protocols to differentiate in between the NSTEMI and unstable angina can be differentiated and treated. On the other hand, these new protocols are improving. As the basic treatment lies in solving the underlying pathology, the concentration on antiplatelets therapy and different invasive therapies like PCI and CABG, there are several new things which are required to be considered. There are different trials which are done on the patients and the results are discussed at AHA, ACC, European Society of Cardiology, ISAR-COOL, ABROAD, TIMACS etc, all agree for the introduction of the several new therapies that are required to intervene in the golden hour management before sending the patient to CCU.
These new protocols are underlying to select the patient on the personal choices rather than choosing electively for the angiography, hence, talking the patients to have them. Not only these early yet invasive methods will minimize the different complications of MI, but the efficacy of the drugs that are being used to prevent the stroke, pericarditis, myocarditis, etc will help a lot. Among the drugs that can be used in high doses in the early stage of management include the Clopedogril, etc. According to the clinical trial that has been done by TRITON-TIMI 38, using Clopedogril in high doses with the dyspeptic agents will be quite beneficial to prevent the complications arising from the PCI for MI.