THE EVOLVING LANDSCAPE OF ACS IN THE EMERGENCY SETTING: FOCUS ON ANTIPLATELET AND ANTICOAGULATION THERAPY

THE EVOLVING LANDSCAPE OF ACS IN THE EMERGENCY SETTING: FOCUS ON ANTIPLATELET AND ANTICOAGULATION THERAPY

Transcript monograph from the 2013 EMCREG-International Symposium held in Seattle, Washington on October 13, 2013. This is presented as an interactive piece which features discussion of the new 2012 ACCF/AHA Guideline for the Treatment of Non-ST-segment Elevation Myocardial Infarction and Unstable Angina and the 2013 ACCF/AHA Guideline for the treatment of ST-segment Elevation Myocardial Infarction. Emphasis will be placed on the antiplatelet and anticoagulant portion of the guidelines.

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RISK STRATIFICATION FOR PATIENTS WITH NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROMES IN THE EMERGENCY DEPARTMENT

RISK STRATIFICATION FOR PATIENTS WITH NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROMES IN THE EMERGENCY DEPARTMENT

Unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) accounted for 1,295,000 hospital admissions in the US in 2001, almost 60% of those patients were 65 years of age or older, and 41% were women. The National Center for Health Statistics recently reported 5,637,000 US emergency department (ED) chest-pain syndrome visits, accounting for approximately 5% of total visits. Accurate diagnosis and risk stratification of the UA/NSTEMI patient is essential to identify patients at risk and to initiate appropriate treatment.

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CARDIOVASCULAR and NEUROVASCULAR EMERGENCIES: IMPLICATIONS FOR CLINICAL PRACTICE (2003)

CARDIOVASCULAR and NEUROVASCULAR EMERGENCIES: IMPLICATIONS FOR CLINICAL PRACTICE (2003)

Patients presenting to the Emergency Department (ED) with chest pain remain a major clinical challenge. In the United States alone there are over eight million annual visits for this problem, resulting in over four million admissions. Nontraumatic chest discomfort remains the primary catalyst for ED evaluation of possible acute coronary syndromes, including unstable angina, non-ST-segment elevation myocardial infarction and ST-segment myocardial infarction. The diagnosis and treatment of congestive heart failure is also critically important to emergency physicians and other healthcare providers. The diagnosis of cerebrovascular disease is equally difficult, with up to one million patients presenting to the emergency department with stroke each year. Therefore, it is essential that emergency physicians remain on the forefront of state of the art diagnostic and treatment options involving the newest regimens for ACS, CHF, and stroke.

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ACC/AHA 2002 Guidelines for the Management of Patients with Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: A SUMMARY FOR EMERGENCY PHYSICIANS

ACC/AHA 2002 Guidelines for the Management of Patients with Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: A SUMMARY FOR EMERGENCY PHYSICIANS

Current literature and clinical practice places a substantial emphasis on evidence-based medicine and evidence-based practice guidelines. In the year 2000, the American College of Cardiology (ACC) and American Heart Association (AHA) published comprehensive, evidence-based guidelines on the management of patients with unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI). In 2002, these guidelines were updated due to the remarkable clinical advances in the care of these patients. Many aspects of these guidelines pertain directly to emergency physicians.

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