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ACC/AHA release revised UA/NSTEMI guidelines

The American College of Cardiology and the American Heart Association have jointly released revised Guidelines for the Management of Patients with Unstable Angina (UA)/Non-ST- Elevation Myocardial Infarction (NSTEMI). Major changes to the guidelines include: suggesting an initial non-invasive set of preliminary tests, such as a stress test, echocardiogram or radionuclide angiogram; recommending the use of anti-platelet therapy clopidogrel for at least one year after receiving a drug-eluting stent; highlighting the importance of more intense lipid and blood pressure control; and advising cessation of non-steroidal anti-inflammatory drugs (NSAIDS) use for all UA/NSTEMI patients during hospitalization.

Coronary artery disease (CAD) is the leading cause of death in the United States, and UA and NSTEMI are acute manifestations of this condition. In 2004, the National Center for Health Statistics reported 669,000 hospitalizations for UA and 896,000 for myocardial infarction. Unstable angina, which causes chest pain and discomfort, occurs when a coronary artery is partially blocked. Myocardial infarction, or heart attack, occurs when a coronary artery is completely blocked, cutting off blood flow to the heart resulting in death of heart muscle.

The ability to detect and treat these conditions earlier has greatly improved over the last several years. New evidence from pivotal trials over the past five years has been gathered together in these guidelines to give physicians up-to-date and detailed information on which treatment options will provide the best possible outcomes for their patients, said Nanette K. Wenger, M.D., F.A.C.C., F.A.H.A., a member of the guidelines writing committee and professor of medicine in the Division of Cardiology at Emory University School of Medicine in Atlanta. This is a major educational document for health professionals, and I trust it will become part of the core teaching for medical students, residents and graduate
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Contact: Amy Murphy
amurphy@acc.org
202-375-6476
American College of Cardiology
6-Aug-2007


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