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Myocardial Infarction: Difference between revisions
→Non-ST-Segment Elevation Acute Coronary Syndrome
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Comparable to STEMI, revascularization in NSTE-ACS relieves symptoms, shortens hospital | Comparable to STEMI, revascularization in NSTE-ACS relieves symptoms, shortens hospital | ||
stay, and improves prognosis. However, NSTE-ACS patients represent a heterogeneous population, and indication and timing of revascularization depend on many factors, including the baseline risk of the patient. According to current guidelines, depending on early risk stratification a choice has to be made between a routine invasive or a selective invasive (or “conservative strategy”) <Cite>REFNAME27</Cite> | stay, and improves prognosis. However, NSTE-ACS patients represent a heterogeneous population, and indication and timing of revascularization depend on many factors, including the baseline risk of the patient. According to current guidelines, depending on early risk stratification a choice has to be made between a routine invasive or a selective invasive (or “conservative strategy”) <Cite>REFNAME27</Cite> | ||
Early risk stratification is helpful to identify patients at high risk who might benefit the most from a more aggressive therapeutic approach in order to prevent further ischemic events. <Cite>REFNAME28</Cite> | Early risk stratification is helpful to identify patients at high risk who might benefit the most from a more aggressive therapeutic approach in order to prevent further ischemic events. <Cite>REFNAME28</Cite> | ||
Early risk stratification can be performed using one of the validated risk scores, such as the TIMI risk score: | Early risk stratification can be performed using one of the validated risk scores, such as the TIMI risk score: | ||
*Age ≥65 years | |||
*Presence of at least three risk factors for coronary heart disease (hypertension, diabetes, dyslipidemia, smoking, or positive family history of early MI) | |||
*Prior coronary stenosis of ≥50 percent | |||
*Presence of ST segment deviation on admission ECG | |||
*At least two anginal episodes in prior 24 hours | |||
*Elevated serum cardiac biomarkers | |||
*Use of aspirin in the prior seven days | |||
Patients with a score of 0 to 1 are at low risk, score 2 to 3 are at intermediate risk, score 4 to 6 are at high risk. | Patients with a score of 0 to 1 are at low risk, score 2 to 3 are at intermediate risk, score 4 to 6 are at high risk. | ||