Acute Coronary Syndrome part 2 Flashcards
see chart of slide 4/5
ok
who is the early invasive strategy used for in nstemi/ua, waht does it involve
angiography and maybe revascularization wihtin 24 hours
indicated for high risk patients (timi>2) or other high risk factors
who may be referred for cabg
high risk patients with multivessel disease
ischemia guided strategy drugs
initiate dapt and anticoagulant
- asa
- p2y12
- anticoagulant - ufh,lmwh
whats the adjunct pharmacotherapy in nstemi/ua
continue dapt anticoagulant discontinued adter pci beta blocker acei statin nitrates prn
early invasive strategy in nstemi/ua drugs
asa
p2y12 loading dose
anticoagulant
consider GPIIb/IIIa inhibitors in high risk patients
who is the ischemia guided strategy used for
patients with low risk factors just get medical management
may be referred for revascularization if ischemia worsens or new high risk occurs
what is the dapt therapy in nstemi/ua
how long
if underwent early invasive with pci should recieve same dapt as stemi
with ischemia strategy use asa plus ticagrelor or clopidogrel
all for 1 year
what was the result of the cure trial for clopidogrel and asa vs asa alone
clopidogrel + asa in us/nstemi patients reduces the risk in cv outcomes
some increase in major bleeding
high risk benefit patients derive most benefit
what was the result of the plato trial in ticegrelor +asa vs clopidogrel + asa
ticagrelor high risk reduction
no sig increase in major bleed
still fine to use clopidegrel in low risk patients
what timi score would you recommend early invasive
4 and up
glycoprotein 2b/3a receptor antagonist moa
block binding of fibrinogen to GPIIb/IIIa receptor on platelet surface inhibiting platelet aggregation
examples of glycoprotein recrpto antagonists
abciximab
eptifibatide
tirofiban
what does glycoprotein ra do in patients with ua/acs who undergo pci
reduce death/mi
improved outcomes with anticoagulants
prevent progression to mi and death
