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This useful ebook presents a finished evaluation of the epidemiology and scientific presentation of acute coronary syndromes (ACS). It additionally courses the reader via hazard overview, possibility stratification, analysis, and remedy of ACS.

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Is clopidogrel cardiovascular medicine’s double-edged sword? Circulation 2006; 113:1638–1640. 19. ; JUMBO-TIMI 26 Investigators. Randomized comparison of prasugrel (CS-747, LY640315), a novel thienopyridine P2Y12 antagonist, with clopidogrel in percutaneous coronary intervention: results of the Joint Utilization of Medications to Block Platelets Optimally (JUMBO)–TIMI 26 trial. Circulation 2005; 111:3366–3373. 20. ; TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes.

Clopidogrel recommendation Clopidogrel should be used instead of aspirin in patients with ACS who have a significant allergy to aspirin [4,5]. For other patients, clopidogrel should be used in addition to aspirin early during the hospitalization [4,5]. This is especially true among patients with ACS [4], including patients with ST-elevation myocardial infarction [5]. 3) [15,16], including those with a drug-eluting stent [17]. , before coronary angiography) somewhat problematic, although not prohibitive, due to concerns of surgical bleeding [18].

The precise role of this agent in patients with ACS who are treated aggressively with a glycoprotein IIb/IIIa inhibitor and early invasive therapy is unknown. Clopidogrel has also been shown to be beneficial in the ST-elevation myocardial infarction population [11,12]. The COMMIT (Clopidogrel and Metroprolol in Myocardial Infarction) trial studied over 45,000 patients with ST-elevation myocardial infarction, of whom half received fibrinolytic therapy (the remainder were conservatively treated) [12].

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