Unstable angina pectoris

Comments

This excellent review looks at the pathogenesis, medical management and revascularisation procedures involved in this coronary syndrome. The trials involving aspirin, ticlopidine, clopidogrel, platelet glycoprotein IIb/IIIa receptor antagonists and antithrombin therapies in unstable angina are highlighted, and conventional medical therapies discussed (beta-blockers, nitrates and calcium-channel blockers). The changing attitudes regarding revascularisation procedures, with the advent of coronary stenting and glycoprotein IIb/IIIa receptor inhibition, are explored. In addition, investigations are summarised which stratify the risk of further coronary events and influence decisions on whether medical management can be safely continued, or whether angiography and myocardial revascularisation procedures are required. Finally a flow diagram of treatment strategies is presented which stratifies patients into low, intermediate and high risk groups.