Fast Five Quiz: Test Your Knowledge of Acute Coronary Syndrome

Yasmine S. Ali, MD

Disclosures

April 26, 2017

An early invasive strategy (ie, diagnostic angiography with intent to perform revascularization) is indicated in patients with unstable angina/NSTEMI who have refractory angina or hemodynamic or electrical instability without serious comorbidities or contraindications to such procedures. An early invasive strategy is also indicated in initially stabilized patients with unstable angina/NSTEMI who do not have serious comorbidities or contraindications to such procedures and who have an elevated risk for clinical events.

In complete vessel occlusion without collateralization of the infarct-related vessel, "pushing nitrates" is of little use.

Dual antiplatelet therapy with clopidogrel and aspirin, compared with aspirin alone, reduces major cardiovascular events in patients with established ischemic heart disease; it also reduces coronary stent thrombosis but is not routinely recommended for patients with prior ischemic stroke because of the risk for bleeding.

The use of eptifibatide 12 hours or more before angiography was not superior to the provisional use of eptifibatide after angiography, according to results of the EARLY ACS trial. The study compared a strategy of early, routine administration of eptifibatide with delayed, provisional administration in patients who had ACS without ST-segment elevation and who were assigned to an invasive strategy. The study also found that early use of eptifibatide was associated with an increased risk for non–life-threatening bleeding and the need for transfusion.

For more on the treatment of ACS, read here.

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