Risk Stratification and Invasive Strategy in NSTE-ACS

Under the heading of acute coronary syndrome (ACS), we include myocardial infarction with ST segment elevation (STEMI), myocardial infarction without ST segment elevation (NSTEMI) and unstable angina (UA). Given the similar pathophysiological mechanisms, clinical manifestations, diagnostic and therapeutic algorithm UA and NSTEMI are sorted into a common group of ACS without ST segment elevation (NSTE-ACS). ACS is a serious clinical disease, which is associated with higher mortality than stable angina pectoris. High proportion of patients die of sudden death in the early hours of ACS (especially STEMI), before admission to the hospital, therefore it is difficult to assess the real incidence of ACS. The incidence of ACS also depends on the sensitivity of the humoral markers of myocyte necrosis. The annual hospital admissions rate for NSTE-ACS is estimated from the results of registers and surveys about 3 per 1000 inhabitants. The proportion of STEMI represents approximately 20% of NSTE ACS.