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Acute coronary syndrome

Prevalence
Clinical features
Differential diagnosis
Investigations
Therapy
Prevention
Prognosis
Therapy

For patients with ECG changes or elevated cardiac enzymes, add a tirofiban or eptifibatide a  

Why?

  • Patients with unstable angina or non-ST segment elevation MI who receive a glycoprotein IIb/IIIa inhibitors compared with standard medical therapy are less likely to die or have a myocardial infarction, but more likely to have severe bleeding. a

Adding glycoprotein IIb/ IIIa inhibitors to standard therapy reduces mortality and further ischaemia

Patient Treatment Comparison Outcome CER OR
(95% CI)
NNT
(95% CI)
unstable angina or non-ST elevation MI   a glycoprotein IIb/ IIIa inhibitor standard medical therapy death or myocardial infarction
at 6 months
15% 0.88
(0.81 to 0.95)
65
(41 to 160)
major bleeding
at 6 months
3.6% 1.26
(1.12 to 1.43)
-110
(-240 to -68)

 

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