Current Management of Non-ST-Segment Elevation Acute Coronary Syndrome

被引:1
作者
Diez-Villanueva, Pablo [1 ]
Jimenez-Mendez, Cesar [2 ]
Cepas-Guillen, Pedro [3 ]
Arenas-Loriente, Andrea [3 ]
Fernandez-Herrero, Ignacio [4 ]
Garcia-Pardo, Hector [5 ]
Diez-Delhoyo, Felipe [4 ]
机构
[1] Hosp Univ Princesa, Cardiol Dept, Madrid 28006, Spain
[2] Hosp Univ Puerta Del Mar, Cardiol Dept, Cadiz 11009, Spain
[3] Hosp Clin Barcelona, Cardiol Dept, Barcelona 08036, Spain
[4] Hosp Univ Doce Octubre, Cardiol Dept, Madrid 28041, Spain
[5] Hosp Univ Rio Hortega, Cardiol Dept, Valladolid 47012, Spain
关键词
acute coronary syndrome; non-ST-elevation coronary syndrome; antiplatelet therapy; revascularization; cardiac rehabilitation; elderly; DUAL ANTIPLATELET THERAPY; TICAGRELOR PLUS ASPIRIN; CARDIAC REHABILITATION; ANTITHROMBOTIC THERAPY; MYOCARDIAL-INFARCTION; CARDIOVASCULAR EVENTS; ATRIAL-FIBRILLATION; OPEN-LABEL; INTERVENTION; CLOPIDOGREL;
D O I
10.3390/biomedicines12081736
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Cardiovascular disease constitutes the leading cause of morbimortality worldwide. Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) is a common cardiovascular condition, closely related to the ageing population and significantly affecting survival and quality of life. The management of NSTE-ACS requires specific diagnosis and therapeutic strategies, thus highlighting the importance of a personalized approach, including tailored antithrombotic therapies and regimens, combined with timely invasive management. Moreover, specific and frequent populations in clinical practice, such as the elderly and those with chronic kidney disease, pose unique challenges in the management of NSTE-ACS due to their increased risk of ischemic and hemorrhagic complications. In this scenario, comprehensive management strategies and multidisciplinary care are of great importance. Cardiac rehabilitation and optimal management of cardiovascular risk factors are essential elements of secondary prevention since they significantly improve prognosis. This review highlights the need for a personalized approach in the management of NSTE-ACS, especially in vulnerable populations, and emphasizes the importance of precise antithrombotic management together with tailored revascularization strategies, as well as the role of cardiac rehabilitation in NSTE-ACS patients.
引用
收藏
页数:16
相关论文
共 93 条
[1]   Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology [J].
Ambrosetti, Marco ;
Abreu, Ana ;
Corra, Ugo ;
Davos, Constantinos H. ;
Hansen, Dominique ;
Frederix, Ines ;
Iliou, Marie C. ;
Pedretti, Roberto F. E. ;
Schmid, Jean-Paul ;
Vigorito, Carlo ;
Voller, Heinz ;
Wilhelm, Mathias ;
Piepoli, Massimo F. ;
Bjarnason-Wehrens, Birna ;
Berger, Thomas ;
Cohen-Solal, Alain ;
Cornelissen, Veronique ;
Dendale, Paul ;
Doehner, Wolfram ;
Gaita, Dan ;
Gevaert, Andreas B. ;
Kemps, Hareld ;
Kraenkel, Nicolle ;
Laukkanen, Jari ;
Mendes, Miguel ;
Niebauer, Josef ;
Simonenko, Maria ;
Zwisler, Ann-Dorthe Olsen .
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 2021, 28 (05) :460-495
[2]  
Amsterdam EA, 2014, J AM COLL CARDIOL, V64, pE139, DOI [10.1016/j.jacc.2014.09.017, 10.1016/j.jacc.2014.10.011, 10.1016/j.jacc.2014.09.016, 10.1161/CIR.0000000000000134]
[3]   Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS [J].
Baber, Usman ;
Dangas, George ;
Angiolillo, Dominick Joseph ;
Cohen, David Joel ;
Sharma, Samin Kumar ;
Nicolas, Johny ;
Briguori, Carlo ;
Cha, Jin Yu ;
Collier, Timothy ;
Dudek, Dariusz ;
Dzavik, Vladimir ;
Escaned, Javier ;
Gil, Robert ;
Gurbel, Paul ;
Hamm, Christian W. ;
Henry, Timothy ;
Huber, Kurt ;
Kastrati, Adnan ;
Kaul, Upendra ;
Kornowski, Ran ;
Krucoff, Mitchell ;
Kunadian, Vijay ;
Marx, Steven Owen ;
Mehta, Shamir ;
Moliterno, David ;
Ohman, Erik Magnus ;
Oldroyd, Keith ;
Sardella, Gennaro ;
Sartori, Samantha ;
Shlofmitz, Richard ;
Steg, Philippe Gabriel ;
Weisz, Giora ;
Witzenbichler, Bernhard ;
Han, Ya-Ling ;
Pocock, Stuart ;
Gibson, Charles Michael ;
Mehran, Roxana .
EUROPEAN HEART JOURNAL, 2020, 41 (37) :3533-3545
[4]  
Balady GJ, 2007, J CARDIOPULM REHABIL, V27, P121
[5]  
Barker Kathryn, 2018, J Comorb, V8, p2235042X18783918, DOI 10.1177/2235042X18783918
[6]   One-year clinical outcomes in older patients with non-ST elevation acute coronary syndrome undergoing coronary angiography: An analysis of the ICON1 study [J].
Batty, Jonathan ;
Qiu, Weiliang ;
Gu, Sophie ;
Sinclair, Hannah ;
Veerasamy, Murugapathy ;
Beska, Benjamin ;
Neely, Dermot ;
Ford, Gary ;
Kunadian, Vijay .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2019, 274 :45-51
[7]   Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 [J].
Bikbov, Boris ;
Purcell, Carrie ;
Levey, Andrew S. ;
Smith, Mari ;
Abdoli, Amir ;
Abebe, Molla ;
Adebayo, Oladimeji M. ;
Afarideh, Mohsen ;
Agarwal, Sanjay Kumar ;
Agudelo-Botero, Marcela ;
Ahmadian, Elham ;
Al-Aly, Ziyad ;
Alipour, Vahid ;
Almasi-Hashiani, Amir ;
Al-Raddadi, Rajaa M. ;
Alvis-Guzman, Nelson ;
Amini, Saeed ;
Andrei, Tudorel ;
Andrei, Catalina Liliana ;
Andualem, Zewudu ;
Anjomshoa, Mina ;
Arabloo, Jalal ;
Ashagre, Alebachew Fasil ;
Asmelash, Daniel ;
Ataro, Zerihun ;
Atout, Maha Moh'd Wahbi ;
Ayanore, Martin Amogre ;
Badawi, Alaa ;
Bakhtiari, Ahad ;
Ballew, Shoshana H. ;
Balouchi, Abbas ;
Banach, Maciej ;
Barquera, Simon ;
Basu, Sanjay ;
Bayih, Mulat Tirfie ;
Bedi, Neeraj ;
Bello, Aminu K. ;
Bensenor, Isabela M. ;
Bijani, Ali ;
Boloor, Archith ;
Borzi, Antonio M. ;
Camera, Luis Alberto ;
Carrero, Juan J. ;
Carvalho, Felix ;
Castro, Franz ;
Catala-Lopez, Ferran ;
Chang, Alex R. ;
Chin, Ken Lee ;
Chung, Sheng-Chia ;
Cirillo, Massimo .
LANCET, 2020, 395 (10225) :709-733
[8]   Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes:: a meta-analysis of all major randomised clinical trials [J].
Boersma, E ;
Harrington, RA ;
Moliterno, DJ ;
White, H ;
Théroux, P ;
Van de Werf, F ;
de Torbal, A ;
Armstrong, PW ;
Wallentin, LC ;
Wilcox, RG ;
Simes, J ;
Califf, RM ;
Topol, EJ ;
Simoons, ML .
LANCET, 2002, 359 (9302) :189-198
[9]   Ischaemic risk and efficacy of ticagrelor in relation to time from P2Y12 inhibitor withdrawal in patients with prior myocardial infarction: insights from PEGASUS-TIMI 54 [J].
Bonaca, Marc P. ;
Bhatt, Deepak L. ;
Steg, P. Gabriel ;
Storey, Robert F. ;
Cohen, Marc ;
Im, Kyungah ;
Ophuis, Ton Oude ;
Budaj, Andrej ;
Goto, Shinya ;
Lopez-Sendon, Jose ;
Diaz, Rafael ;
Dalby, Anthony ;
Van de Werf, Frans ;
Ardissino, Diego ;
Montalescot, Gilles ;
Aylward, Philip ;
Magnani, Giulia ;
Jensen, Eva C. ;
Held, Peter ;
Braunwald, Eugene ;
Sabatine, Marc S. .
EUROPEAN HEART JOURNAL, 2016, 37 (14) :1133-1142
[10]  
Byrne RA, 2024, EUR HEART J-ACUTE CA, V13, P55, DOI 10.1093/ehjacc/zuad107