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Acute coronary syndrome

Prevalence
Clinical features
Differential diagnosis
Investigations
Therapy
Prevention
Prognosis
Prognosis

Patients are at increased risk of dying, having an MI or requiring revascularisation with:
  • An MI within the previous 14 days a b or angina at rest within the previous 48 h a b
  • history of or current congestive heart failure b
  • tachycardia or low blood pressure on admission b

Why?

Recent angina at rest or a myocardial infarction increases the risk of dying or infarction

Patient Prognostic factor Outcome CER OR 
(95% CI)
NNT
(95% CI)
unstable angina a MI within last 14 days
independent
death or MI  
at 6 months
7.6% 5.72 
(1.92 to 16.97)

(2 to 16)
unstable angina a angina at rest in the previous 48 h
independent
death, MI or revascularisation
  at 6 months
42%
(2.1 to 4.3)

(61 to 15)

 

Expiry date: June 2003
Levels of Evidence used in grading these guides

Authors   CM   Ball , N   Shenker
Reviewer   I K   Jang
CAT Writers   N   Shenker , CJ   Wotton , CM   Ball , RS   Phillips