Myocardial Infarction: Difference between revisions

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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 heterogeneous 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 heterogeneous 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>


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>
Early risk stratification can be performed using one of the validated risk scores, such as the TIMI risk score:  
Early risk stratification can be performed using one of the validated risk scores, such as the TIMI risk score:  
:- Age ≥65 years
*Age ≥65 years
:- Presence of at least three risk factors for coronary heart disease (hypertension, diabetes, dyslipidemia, smoking, or positive family history of early MI)
*Presence of at least three risk factors for coronary heart disease (hypertension, diabetes, dyslipidemia, smoking, or positive family history of early MI)
:- Prior coronary stenosis of ≥50 percent
*Prior coronary stenosis of ≥50 percent
:- Presence of ST segment deviation on admission ECG
*Presence of ST segment deviation on admission ECG
:- At least two anginal episodes in prior 24 hours
*At least two anginal episodes in prior 24 hours
:- Elevated serum cardiac biomarkers
*Elevated serum cardiac biomarkers
:- Use of aspirin in the prior seven days
*Use of aspirin in the prior seven days
 


Patients with a score of 0 to 1 are at low risk, score 2 to 3 are at intermediate risk, score 4 to 6 are at high risk.   
Patients with a score of 0 to 1 are at low risk, score 2 to 3 are at intermediate risk, score 4 to 6 are at high risk.