علاج الذبحة الصدرية غير المستقرة مع معايير عالية الخطورة جداً في NSTE-ACS

References

DOI: 10.1093/eurheartj/ehad191

• An immediate invasive strategy is recommended in patients with a working diagnosis of NSTE-ACS and with at least one of the following very high-risk criteria:
• Haemodynamic instability or cardiogenic shock
• Recurrent or refractory chest pain despite medical treatment
• In-hospital life-threatening arrhythmias
• Mechanical complications of MI
• Acute heart failure presumed secondary to ongoing myocardial ischaemia
• Recurrent dynamic ST-segment or T wave changes, particularly intermittent ST-segment elevation.
• An immediate invasive strategy refers to emergency (i.e. as soon as possible) angiography and PCI if indicated.
• In all ACS patients, a P2Y12 receptor inhibitor is recommended in addition to aspirin, given as an initial oral LD followed by an MD for 12 months unless there is HBRc.
• Parenteral anticoagulation is recommended for all patients with ACS at the time of diagnosis.