Circulation Research is available at http://circres.ahajournals.org DOI: 10.1161/CIRCRESAHA.114.302744 Abstract: The appropriate timing of angiography to facilitate revascularization is essential to optimize outcomes in patents with ST-segment–elevation myocardial infarction and non–ST-segment–elevation acute coronary syndromes. Timely reperfusion of the infarct-related coronary artery in ST-se...

There are currently almost no genetic data associated with the acute coronary syndromes of unstable angina or myocardial infarction (MI). The only documented genetic variants associated with increased risk for MI, per se, are the A and B blood group variants. There are no genetic data differentially associated with ST segment elevation MI or non-ST segment elevation MI. Genetic variants predisp...

Antithrombotic therapy is an essential part of the management of the full spectrum of acute coronary syndromes (ACS). Both antiplatelets and anticoagulants seem to be necessary in the management of ACS (Figures 1 and 2), although the exact proportion of antithrombotic effect that each drug and class should ideally provide remains a matter of ongoing study. As a general principle, more potent an...

WTM 0219/UPDATE About programme updates The Centre for Pharmacy Postgraduate Education (CPPE) has a quality assurance process called programme guardians. A programme guardian is a recognised expert in an area relevant to the content of a learning programme who reviews the programme every six to eight months. Following the regular programme guardian review we have developed this update to inform...

The benefits of aggressive lipid-lowering therapy in reducing long-term cardiovascular morbidity and mortality have been firmly established, both in patients with established stable coronary artery disease (CAD) and in high-risk patients without clinically apparent CAD. Although lipid-lowering agents, in particular the 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors (statin...

1. Blake GJ, Ridker PM. C-reactive protein and other inflammatory risk markers in acute coronary syndromes. J Am Coll Cardiol 2003;41: S37–42. 2. Huber C, Batchelor JR, Fuchs D, et al. Immune response-associated production of neopterin. Release from macrophages primarily under control of interferongamma. J Exp Med 1984;160:310–6. 3. Werner-Felmayer G, Werner ER, Fuchs D, et al. Pteridine biosyn...

Acute coronary syndromes such as unstable angina or myocardial infarction often develop unexpectedly and severely interrupt a patient’s life. Two main pathological processes, atherosclerosis and thrombosis, lead to acute coronary syndromes such as unstable angina and myocardial infarction.1,2 The typical atherosclerotic lesion is a fibrolipid plaque composed of a pool of lipids covered with a c...

An indisputable body of angiographic, angioscopic, pathological, and biochemical evidence supports the role of thrombus in the pathogenesis of acute myocardial infarction, unstable angina, and percutaneous coronary intervention. Compelling data from large-scale trials and analyses have established the role of platelet inhibitors in reducing coronary events in patients with the acute coronary sy...

Inflammation plays a central role in the pathogenesis of acute coronary syndromes, the prevalence of which is increased in individuals with diabetes. Monocytes and macrophages, T cells and mast cells contribute to the initiation, development and rupture of atherosclerotic plaques by synthesising a variety of pro-inflammatory cytokines, including interleukin 1β, interleukin 6 and tumour necrosis...