Redefining medical treatment in the management of unstable angina

Eugene Braunwald, Robert M. Califf, Christopher P. Cannon, Keith A.A. Fox, Valentin Fuster, W. Brian Gibler, Richard A. Harrington, Spencer B. King, Neil S. Kleiman, Pierre Theroux, Eric J. Topol, Frans Van De Werf, Harvey D. White, James T. Willerson

Research output: Contribution to journalReview article

53 Scopus citations

Abstract

In 1994, the Agency for Health Care Policy and Research sponsored the development of guidelines for diagnosing and managing patients with unstable angina. Since their publication, several important developments have occurred. The prognostic value of biochemical assays for cardiac-specific troponins T and I have been shown in many studies. The possible role for C-reactive protein in determining prognosis deserves further investigation. Substantial clinical benefits have been obtained with intravenous inhibitors of the platelet glycoprotein (GP) IIb-IIIa receptor (abciximab, eptifibatide, tirofiban) and with one of the low-molecular-weight heparins (enoxaparin). The therapeutic potential of other low-molecular-weight heparins, direct thrombin inhibitors, and oral GP IIb-IIIa inhibitors remains to be clarified. On the basis of this evidence, consideration should be given to measuring serum levels of a cardiac troponin (either T or I) and using intravenous GP IIb-IIIa inhibitors and low-molecular-weight heparin in the standard management of patients with unstable angina. Copyright (C) 2000 Excerpta Medica Inc.

Original languageEnglish (US)
Pages (from-to)41-53
Number of pages13
JournalAmerican Journal of Medicine
Volume108
Issue number1
DOIs
StatePublished - Jan 2000

ASJC Scopus subject areas

  • Medicine(all)

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