Treatment of patients with acute (unstable) symptoms due to coronary artery disease

Management of high-risk subsets in unstable angina

This article focuses on the optimal treatment of postinfarction, refractory, or recurrent angina based on the results of recent clinical trials. Many of our recommendations hold true for the general management of unstable angina, but special considerations for the high-risk subsets are emphasized. Specifically, we discuss acute medical management and suggest that an early aggressive strategy that leads to early coronary angiography with the goal of revascularization when feasible best serves this subset. A special emphasis on the emerging role of glycoprotein IIb-IIIa antagonists is made because the important role of platelets in coronary thrombosis has dominated recent views on the pathophysiology of unstable angina.