The clinical presentation of ischaemic heart disease includes stable and unstable angina pectoris, silent ischaemia, myocardial infarction, heart failure and sudden death [1]. For many years, unstable angina has been considered an intermediate syndrome between chronic stable angina and acute myocardial infarction. In recent years, its pathophysiology has been clarified and acute coronary syndro...

BACKGROUND Despite improvements in the emergency treatment of myocardial infarction (MI), early mortality and morbidity remain high. The antiplatelet agent clopidogrel adds to the benefit of aspirin in acute coronary syndromes without ST-segment elevation, but its effects in patients with ST-elevation MI were unclear. METHODS 45,852 patients admitted to 1250 hospitals within 24 h of suspected...

N on-ST-elevation myocardial infarction (NSTEMI) is lower on the severity spectrum of acute coronary syndromes than is myocardial infarction (MI), resulting from complete occlusion of a major coronary artery. As the name implies, it is a syndrome that does not exhibit the dramatic ST elevation observed in the standard 12-lead ECG in chest pain patients with confirmed acute MI. The important cli...

• Objective: To review the clinical trials of glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitors for unstable angina or non–ST segment elevation myocardial infarction (MI) and to provide a practice guide for the use of these agents in this setting. • Methods: Clinical trials relating to GPIIb/IIIa antagonists and acute coronary syndromes were identified from a MEDLINE search of articles published be...

OBJECTIVES Risk scores are recommended in guidelines to facilitate the management of patients who present with acute coronary syndromes (ACS). Internationally, such scores are not systematically used because they are not easy to apply and some risk indicators are not available at first presentation. We aimed to derive and externally validate a more accurate version of the Global Registry of Acu...

OBJECTIVE To determine to what extent evidence based guidelines are followed in the management of acute coronary syndromes (ACS) in the UK, elsewhere in Europe, and multinationally, and what the outcomes are. DESIGN Multinational, prospective, observational registry (GRACE, global registry of acute coronary events) with six months' follow up. SETTING Patients presenting to a cluster of hosp...

Objective: To determine to what extent evidence based guidelines are followed in the management of acute coronary syndromes (ACS) in the UK, elsewhere in Europe, and multinationally, and what the outcomes are. Design: Multinational, prospective, observational registry (GRACE, global registry of acute coronary events) with six months’ follow up. Setting: Patients presenting to a cluster of hospi...

Background and Objective: Acute myocardial infarction (MI) is caused due to coronary artery occlusion and divided into two forms of ST-elevation (STEMI) and non-ST-elevation (NSTEMI) myocardial infarction. This study aimed to determine the success rate of treatment with primary PCI (percutaneous coronary intervention) versus thrombolysis in the establishment of perfusion and to evaluate the sho...

When faced with a patient with acute chest pain, clinicians must distinguish myocardial infarction (MI) from all other causes of acute chest pain. If MI is suspected, current therapeutic practice includes deciding whether to administer thrombolysis or primary percutaneous transluminal coronary angioplasty and whether to admit patients to a coronary care unit. The former decision is based on ele...