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This sensible e-book offers a complete review of the epidemiology and medical presentation of acute coronary syndromes (ACS). It additionally courses the reader via probability evaluation, chance stratification, analysis, and remedy of ACS.

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Non-ST-elevation myocardial infarction) without any other TIMI risk score variables should still receive early invasive therapy, even though this model would have predicted low risk for future events. Accordingly, for this model to effectively predict which patients will benefit from invasive therapy, it is likely best reserved for individuals with unstable angina and those with chest pain of unclear etiology. Among these individuals, the TIMI risk score can provide excellent prognostic information that can be used to determine the degree of anti-platelet and anti-thrombin therapy as well as the need for early invasive therapy.

Variables, such as electrocardiographic changes and elevated biomarkers, are important, although when used independently they fail to fully predict a patient’s risk. For electrocardiographic changes, there is a spectrum of risk where small T-wave inversions predict the lowest risk, and ST-elevation along with areas of depression predict higher risk [1]. Similarly for biomarkers, there is also a spectrum of risk that rises with increasing levels of cardiac biomarkers [2]. A. L. 1007/978-1-84800-358-3_4, © Springer-Verlag London Limited 2009 23 24 Acute Coronary Syndromes in Clinical Practice prognosis, attempts have been made to construct accurate and easy-to-use risk models that incorporate multiple variables.

2) [7]. This benefit was achieved without an increase in major bleeding. The SYNERGY (Superior Yield of the New Strategy of Enoxaparin, Revascularization and Glycoprotein IIb/IIIa Inhibitors) study deserves special comment [8]. This was a contemporary trial in over 10,000 participants. Overall, 92% of the study participants underwent coronary angiography, 62% received clopidogrel, and 57% received a glycoprotein IIb/IIIa inhibitor. 3) [8]. Part of the explanation for the increased bleeding with enoxaparin may be due to the fact that 75% of the patients received anticoagulation prior to randomization and may have crossed over from one type of therapy to another.

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