Unstable angina and non-Q wave myocardial infarction: does the clinical diagnosis have therapeutic implications?
Stephen M. Zaacks, MDa,
Philip R. Liebson, MD, FACCa,
James E. Calvin, MD, FACCa,
Joseph E. Parrillo, MD, FACCa and
Lloyd W. Klein, MD, FACCa
a Rush Heart Institute and Rush Medical College, Rush-Presbyterian-St. Luke’s Medical Center, Chicago, Illinois, USA
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Figure 1 Meta Analysis of nine trials of glycoprotein IIb/IIIa antagonists in patients with unstable coronary syndromes. Shown are the 95% confidence intervals for the relative risk ratio of adverse events, including myocardial infarction, recurrent ischemia, and death in patients receiving a glycoprotein IIb/IIIa antagonist in addition to standard therapy with aspirin and heparin. The overall relative risk ratio was 0.79 (p = 0.019). Solid circles = lower 95% C.I. for RR; open circles = relative risk; solid triangles = upper 95% C.I. for RR.
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Figure 2 Possible treatment algorithm for patients presenting with a suspected unstable coronary syndrome. Patients presenting to the emergency department with chest pain need to be rapidly separated into a high, medium, or low risk category as specified by Braunwald et al. (110). See text for details. GPIIb/IIIa RA = Glycoprotein IIb/IIIa receptor antagonist.
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