Strategia di "cure" e "tattiche" interventistiche nell'angina instabile/infarto non Q.

Translated title of the contribution: "Cure" and "tactics" interventional strategies in unstable angina/non-Q infarction

Stefano De Servi, Pietro Vandoni, Maurizio D'Urbano, Arnaldo Poli, Raffaela Fetiveau, Francesco Cafiero

Research output: Contribution to journalArticle

Abstract

Early risk stratification and an invasive approach (coronary angiography and reperfusion if indicated) have recently emerged as the treatment of choice in non-ST elevation acute coronary syndromes. An aggressive pharmacologic therapy, i.e. glycoprotein IIb/IIIa antagonists, is also more effective in case of risk assessment at the time of the admission of the patient in the coronary care unit. Recent data have assessed the advantages of abciximab over tirofiban in unstable patients submitted to percutaneous coronary intervention (PCI), whereas non-anticorpal molecules (tirofiban, integrilin) are indicated for the medical treatment of high-risk patients in order to reduce myocardial necrosis during the acute phase. A good platelet inhibition with the oral tienopiridine derivative clopidogrel, resulted in a lower incidence of major cardiovascular events at follow-up both in patients treated conservatively as well as in patients submitted to PCI (CURE and PCI-CURE trials). The early risk of myocardial necrosis before coronary revascularization was also reduced by clopidogrel in patients submitted to PCI, an effect already demonstrated with tirofiban and integrilin ("small molecules like" effect). A new therapeutic scheme including, at the time of admission, oral clopidogrel for platelet inhibition, an early risk assessment and the subsequent use of abciximab in the cath lab, if indicated is proposed for the treatment of unstable angina. The advantages associated with the proposed treatment have to be validated by ad hoc studies.

Original languageItalian
Pages (from-to)943-948
Number of pages6
JournalItalian Heart Journal
Volume3
Issue number9 Suppl
Publication statusPublished - Sep 2002

Fingerprint

tirofiban
clopidogrel
Unstable Angina
Infarction
Percutaneous Coronary Intervention
Necrosis
Therapeutics
Blood Platelets
Coronary Care Units
Myocardial Reperfusion
Platelet Glycoprotein GPIIb-IIIa Complex
Patient Admission
Acute Coronary Syndrome
Coronary Angiography
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

De Servi, S., Vandoni, P., D'Urbano, M., Poli, A., Fetiveau, R., & Cafiero, F. (2002). Strategia di "cure" e "tattiche" interventistiche nell'angina instabile/infarto non Q. Italian Heart Journal, 3(9 Suppl), 943-948.

Strategia di "cure" e "tattiche" interventistiche nell'angina instabile/infarto non Q. / De Servi, Stefano; Vandoni, Pietro; D'Urbano, Maurizio; Poli, Arnaldo; Fetiveau, Raffaela; Cafiero, Francesco.

In: Italian Heart Journal, Vol. 3, No. 9 Suppl, 09.2002, p. 943-948.

Research output: Contribution to journalArticle

De Servi, S, Vandoni, P, D'Urbano, M, Poli, A, Fetiveau, R & Cafiero, F 2002, 'Strategia di "cure" e "tattiche" interventistiche nell'angina instabile/infarto non Q.', Italian Heart Journal, vol. 3, no. 9 Suppl, pp. 943-948.
De Servi S, Vandoni P, D'Urbano M, Poli A, Fetiveau R, Cafiero F. Strategia di "cure" e "tattiche" interventistiche nell'angina instabile/infarto non Q. Italian Heart Journal. 2002 Sep;3(9 Suppl):943-948.
De Servi, Stefano ; Vandoni, Pietro ; D'Urbano, Maurizio ; Poli, Arnaldo ; Fetiveau, Raffaela ; Cafiero, Francesco. / Strategia di "cure" e "tattiche" interventistiche nell'angina instabile/infarto non Q. In: Italian Heart Journal. 2002 ; Vol. 3, No. 9 Suppl. pp. 943-948.
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