The updated ACC/AHA guideline recommends use of the thienopyridine clopidogrel (Plavix) in patients who cannot tolerate aspirin (ACC/AHA class I). Medical treatment includes anti-ischemic therapy (oxygen, nitroglycerin, beta blocker), antiplatelet therapy (aspirin, clopidogrel, platelet glycoprotein IIb/IIIa inhibitor), and antithrombotic therapy (heparin, low-molecular-weight heparin). Hospital care consists of appropriate initial triage and monitoring. During the initial evaluation, the history, physical examination, electrocardiogram, and cardiac biomarkers are used to determine the likelihood that the patient has UA/NSTEMI and to aid in risk assessment when the diagnosis is established. Part I of this two-part article discusses the first two components of management. Management of suspected UA/NSTEMI has four components: initial evaluation and management hospital care coronary revascularization and hospital discharge and post-hospital care. This guideline, which was published in 2000 and updated in 2002, highlights recent medical advances and is a practical tool to help physicians provide medical care for patients with UA/NSTEMI. To help standardize the assessment and treatment of these patients, the American College of Cardiology and the American Heart Association convened a task force to formulate a management guideline. hospitals because of unstable angina and non–ST-segment elevation myocardial infarction (UA/NSTEMI). Each year, more than 1 million patients are admitted to U.S.
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