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Angiology. 2017 Aug;68(7):598-607. doi: 10.1177/0003319716676721. Epub 2016 Nov 12.

Antiplatelet Therapy for Non-ST-Segment Elevation Myocardial Infarction in Complex "Real" Clinical Scenarios: A Consensus Document of the "Campania NSTEMI Study Group".

Author information

1
1 U.O.C. Cardiologia Interventistica ed UTIC. Azienda Ospedaliera "G.Rummo" di Benevento.
2
2 Division of Cardiology, Department of Advanced Biomedical Sciences, Universitaà di Napoli "Federico II," Napoli, Italy.
3
3 U.O.C. Cardiologia Interventistica. Azienda Ospedaliera Specialistica dei Colli, Napoli.
4
4 U.O.C. Cardiologia Interventistica ed UTIC. Seconda Università di Napoli, Napoli.
5
5 U.O.C. Cardiologia ed UTIC, Ospedale San Giovanni Bosco, Napoli.
6
6 Cardiologia ed UTIC, Ospedale San Giovanni di Dio ed Ruggi d' Aragona, Salerno.
7
7 Unità operativa di Cardiologia ed UTIC, Ospedale Moscati, Avellino.
8
8 U.O.C. Cardiologia-UTIC. Ospedale S. Anna e S. Sebastiano, Caserta.
9
9 U.O.C. Cardiologia Interventistica ed UTIC. Ospedale Cardarelli, Napoli.
10
10 U.O.C. Cardiologia Interventistica ed UTIC, Ospedale Loreto Mare, Napoli.

Abstract

The incidence of ST-segment elevation myocardial infarction (STEMI) has significantly decreased. Conversely, the rate of non-STEMI (NSTEMI) has increased. Patients with NSTEMI have lower short-term mortality compared to patients with STEMI, whereas at long-term follow-up, the mortality becomes comparable. This might be due to the differences in baseline characteristics, including older age and a greater prevalence of comorbidities in the NSTEMI population. Although antithrombotic strategies used in patients with NSTEMI have been well studied in clinical trials and updated guidelines are available, patterns of use and outcomes in clinical practice are less well described. Thus, a panel of Italian cardiology experts assembled under the auspices of the "Campania NSTEMI Study Group" for comprehensive discussion and consensus development to provide practical recommendations, for both clinical and interventional cardiologists, regarding optimal management of antithrombotic therapy in patients with NSTEMI. This position article presents and discusses various clinical scenarios in patients with NSTEMI or unstable angina, including special subsets (eg, patients aged ≥85 years, patients with chronic renal disease or previous cerebrovascular events, and patients requiring triple therapy or long-term antithrombotic therapy), with the panel recommendations being provided for each scenario.

KEYWORDS:

NSTEMI; PCI; acute myocardial infarction; antiplatelets; antithrombotic

PMID:
28660806
DOI:
10.1177/0003319716676721
[Indexed for MEDLINE]

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