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Q J Med 2001; 94: 5-11
© 2001 Association of Physicians

Review

Present treatment options for unstable angina and non-Q-wave myocardial infarction

S.K.S. Lairikyengbam, A.G. Davies and M.H. Anderson1

From the Department of Medicine, Bronglais General Hospital, Aberystwyth 1 Department of Cardiology, Morriston Hospital, Swansea, UK


   Introduction
 
Unstable angina is one of the commonest life-threatening medical emergencies. Despite enormous advances in the understanding of the pathophysiology of unstable angina, development of newer drugs and modern intervention techniques, there are considerable controversies about its most effective and definitive management. We review the literature to produce an evidence-based practical guide to a uniform approach to managing unstable angina, including non-Q-wave myocardial infarction.

Annually, there are likely to be at least 130 000 cases of unstable angina (UA) in the UK, 130 000 in France, 188 000 in Germany, 129 000 in Italy and 80 000 in Spain.1 In 1991, it constituted about 55% of all coronary care unit (CCU) admissions.2 It may result in death or non-fatal myocardial infarction in up to 20% within 30 days of an ischaemic event.3 Among 9146 patients of UA treated in the Duke University Medical Centre between 1985 and 1992, the highest risk . . . [Full Text of this Article]


   Definition
 

   Classification
 

   Pathophysiology
 

   Evolution of medical management of unstable angina
 
Aspirin and heparin
Anti-anginal drugs
Platelet glycoprotein IIb/IIIa receptor antagonist

   Current strategy for medical management of UA/NQMI
 

   Invasive versus non-invasive approaches in the treatment of unstable angina and non-Q-wave myocardial infarction
 

   Conclusions
 

   Notes
 

   References
 

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