Unstable angina non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for antiplatelet therapy: Difference between revisions
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[Clopidogrel]] 75 mg daily (preferred) or [[ticlopidine]] (in the absence of contraindications) should be given to patients recovering from [[UA]] / [[NSTEMI]] when[[ASA]] is contraindicated or not tolerated because of hypersensitivity or GI intolerance (despite use of gastroprotective agents such as [[PPI]]s). ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]]) | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[Clopidogrel]] 75 mg daily (preferred) or [[ticlopidine]] (in the absence of contraindications) should be given to patients recovering from [[UA]] / [[NSTEMI]] when[[ASA]] is contraindicated or not tolerated because of hypersensitivity or GI intolerance (despite use of gastroprotective agents such as [[PPI]]s). ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki> | ||
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Revision as of 15:13, 5 October 2012
Unstable angina / NSTEMI Microchapters |
Differentiating Unstable Angina/Non-ST Elevation Myocardial Infarction from other Disorders |
Special Groups |
Diagnosis |
Laboratory Findings |
Treatment |
Antitplatelet Therapy |
Additional Management Considerations for Antiplatelet and Anticoagulant Therapy |
Risk Stratification Before Discharge for Patients With an Ischemia-Guided Strategy of NSTE-ACS |
Mechanical Reperfusion |
Discharge Care |
Case Studies |
Unstable angina non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for antiplatelet therapy On the Web |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.
ACC / AHA Guidelines for Convalescent and Long-Term Antiplatelet Therapy[1] (DO NOT EDIT)
Class I |
"1. For UA/NSTEMI patients treated medically without stenting, aspirin (75 to 162 mg per day) should be prescribed indefinitely (Level of Evidence: A) clopidogrel (75 mg per day) should be prescribed for at least 1 month and ideally for up to 1 year. (Level of Evidence: B) " |
"2. Clopidogrel 75 mg daily (preferred) or ticlopidine (in the absence of contraindications) should be given to patients recovering from UA / NSTEMI whenASA is contraindicated or not tolerated because of hypersensitivity or GI intolerance (despite use of gastroprotective agents such as PPIs). (Level of Evidence: A) " |
Class III (No Benefit) |
"1. Dipyridamole is not recommended as an antiplatelet agent in post-UA/NSTEMI patients because it has not been shown to be effective. (Level of Evidence: B) " |
Class IIa |
"1. For UA/NSTEMI patients in whom the physician is concerned about the risk of bleeding, a lower initial aspirin dose after PCI of 75 to 162 mg per day is reasonable. (Level of Evidence: C) " |
Class IIb |
"1. For UA/NSTEMI patients who have an indication for anticoagulation, add warfarin to maintain an international normalization ratio of 2.0 to 3.0. (Level of Evidence: B) " |
"2. Continuation of clopidogrel or prasugrel beyond 15 months may be considered in patients following DES placement. (Level of Evidence: C) " |
See Also
References
- ↑ 2012 Writing Committee Members. Jneid H, Anderson JL, Wright RS, Adams CD, Bridges CR; et al. (2012). "2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 126 (7): 875–910. doi:10.1161/CIR.0b013e318256f1e0. PMID 22800849.