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首页> 外文期刊>Cardiovascular therapeutics >Role of antiischemic agents in the management of non-ST elevation acute coronary syndrome (NSTE-ACS)
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Role of antiischemic agents in the management of non-ST elevation acute coronary syndrome (NSTE-ACS)

机译：抗缺血药在非ST段抬高急性冠脉综合征（NSTE-ACS）的管理中的作用

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摘要

Non-ST elevation acute coronary syndrome (NSTE-ACS) is the commonest acute presentation of coronary artery disease (CAD). Mortality and morbidity of the condition has improved substantially over the last few decades as a result of the cumulative effect of multiple interventions acting via different mechanisms. Despite a significant increase in the rate of coronary intervention, medical therapy continues to retain a central role in the treatment of NSTE-ACS particularly in frail patients where revascularization is inappropriate or when it is incomplete. Several antiischemic agents have been used in the treatment of the condition. Beta blockers are often the first-line choice with calcium channel blockers and nitrates being used as an alternative when beta blockers are contraindicated, or as an addition to achieve optimal symptom control. Newer agents, such as nicorandil, ivabradine, and ranolazine have also been used in refractory cases. Although most of these agents have been extensively studied in large randomized controlled trials in patients with stable CAD or ST elevation acute coronary syndrome (STE-ACS), the evidence supporting their use in NSTE-ACS is less clear cut. In this article, we review various drugs available for controlling ischemia and the latest evidence in support of their use in NSTE-ACS.
机译：非ST抬高急性冠状动脉综合征（NSTE-ACS）是冠状动脉疾病（CAD）的最常见急性表现。在过去的几十年中，由于通过不同机制采取多种干预措施的累积效应，该病的死亡率和发病率已大大改善。尽管冠状动脉介入治疗的比率显着增加，但药物治疗仍在NSTE-ACS的治疗中继续发挥中心作用，尤其是在血管重建不适当或不完全的脆弱患者中。几种抗缺血药已用于治疗该病。 β受体阻滞剂通常是一线选择，当禁忌使用β受体阻滞剂时，钙通道阻滞剂和硝酸盐可用作替代品，或作为实现最佳症状控制的补充。较新的药物，如尼可地尔，伊伐布雷定和雷诺嗪也已用于难治性病例。尽管在稳定的CAD或ST抬高的急性冠状动脉综合征（STE-ACS）患者中，已经对这些药物中的大多数进行了广泛的随机对照试验，但支持它们在NSTE-ACS中使用的证据尚不清楚。在本文中，我们回顾了可用于控制缺血的各种药物以及支持其在NSTE-ACS中使用的最新证据。

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