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World J Cardiol. 2011 Oct 26;3(10):315-21. doi: 10.4330/wjc.v3.i10.315.

Percutaneous treatment in acute coronary syndromes.

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1
Eduardo Alegría-Barrero, Interventional Cardiology, Royal Brompton Hospital, London, SW3 6NP, United Kingdom.

Abstract

Both ST-segment elevation myocardial infarction and non-ST-segment elevation acute coronary syndromes (ACS) are the result of an acute thrombotic lesion obstructing blood flow in the coronary vasculature. Percutaneous treatment has shown to improve clinical outcome in this clinical setting by resolving coronary obstruction with different devices directed to restore coronary blood flow. In comparison with balloon alone angioplasty, implantation of bare metal stents reduced the rate of restenosis and cardiac events, but high rates of restenosis remained, leading to further investigations to develop drug-eluting stents with different pharmacological coatings that reduced restenosis rates and clinical events. In this review, we discuss the current treatment of ACS, reviewing recent randomized clinical trials and advances in medical treatment, including new antiplatelet agents and recent guideline recommendations.

KEYWORDS:

Acute coronary syndromes; Coronary revascularization; Non-ST-elevation myocardial infarction; ST-elevation myocardial infarction; Stent

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