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Myocardial Infarction: Difference between revisions
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===Non-ST-segment elevation Acute Coronary Syndrome=== | ===Non-ST-segment elevation Acute Coronary Syndrome=== | ||
[[Image:Swe.jpg|thumb|right|400px|link=http://www.outcomes-umassmed.org/grace/acs_risk/acs_risk_content.html|The [http://www.outcomes-umassmed.org/grace/acs_risk/acs_risk_content.html GRACE risk score model]]] | |||
Comparable to STEMI, revascularization in NSTE-ACS relieves symptoms, shortens hospital | Comparable to STEMI, revascularization in NSTE-ACS relieves symptoms, shortens hospital | ||
stay, and improves prognosis. However, NSTE-ACS patients represent a heterogenous population, and indication and timing of revascularization depend on many factors, including the baseline risk of the patient. According to current guidelines, depending on early risk stratification a choice has to be made between a routine invasive or a selective invasive (or “conservative strategy”) <Cite>REFNAME27</Cite> | stay, and improves prognosis. However, NSTE-ACS patients represent a heterogenous population, and indication and timing of revascularization depend on many factors, including the baseline risk of the patient. According to current guidelines, depending on early risk stratification a choice has to be made between a routine invasive or a selective invasive (or “conservative strategy”) <Cite>REFNAME27</Cite> | ||
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Early risk stratification is helpful to identify patients at high risk who might benefit the most from a more aggressive therapeutic approach in order to prevent further ischemic events. <Cite>REFNAME28</Cite> | Early risk stratification is helpful to identify patients at high risk who might benefit the most from a more aggressive therapeutic approach in order to prevent further ischemic events. <Cite>REFNAME28</Cite> | ||
{| class="wikitable" cellpadding="0" cellspacing="0" | {| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="500px" | ||
|- | |- | ||
|colspan=" | |colspan="5" align="center"|'''GRACE risk score''' | ||
|- | |- | ||
!Risk Category | !Risk Category | ||
! | !low | ||
! | !Intermediate | ||
!High | |||
|- | |- | ||
| | |NSTEMI Probability of Death In-hospital (%) | ||
|<1 | |<1 | ||
|1-3 | |||
|1-3 | |||
|>3 | |>3 | ||
|- | |- | ||
| | |NSTEMI 6 Month Post-discharge Mortality | ||
|<3 | |<3 | ||
|3-8 | |3-8 | ||
|>8 | |>8 | ||
|- | |- | ||
| | |STEMI In-hospital Mortality (%) | ||
|<2 | |<2 | ||
|2-5 | |2-5 | ||
|>5 | |>5 | ||
|- | |- | ||
| | |STEMI 6 Month Post-discharge Mortality | ||
|<4.4 | |<4.4 | ||
|4.5-11 | |4.5-11 | ||
|>11 | |>11 | ||
|} | |} | ||
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====Cardiac rehabilitation==== | ====Cardiac rehabilitation==== | ||
Cardiac rehabilitation reduces mortality, helps the patient to regain confidence and to resocialise, and helps to reduce risk factors for atherosclerosis. Post-ACS patient should be referred for cardiac rehabilitation. | Cardiac rehabilitation reduces mortality, helps the patient to regain confidence and to resocialise, and helps to reduce risk factors for atherosclerosis. Post-ACS patient should be referred for cardiac rehabilitation. | ||
== References == | == References == | ||
<biblio> | <biblio> | ||