Acute coronary syndrome without ST elevation: implementation of new guidelines

Lancet. 2001 Nov 3;358(9292):1533-8. doi: 10.1016/S0140-6736(01)06585-0.


Unstable angina and non-ST-segment-elevation myocardial infarction have in recent years been recognised as frequent and important clinical manifestations of coronary-artery disease. The European (ESC) and American (ACC/AHA) professional societies last year released guidelines on diagnosis, risk stratification, and treatment of these disorders. These guidelines summarise similarly the current evidence and translate them to clinical practice. Most important changes relate to the inclusion of troponins into the risk stratification algorithm, the addition of low-molecular-weight heparin and glycoprotein IIb/IIIa antagonists to medical treatment, and the role of invasive management for improved long-term outcome. Guidelines are constantly challenged by newly emerging study results. Recently, early invasive management and clopidogrel have been found to exert further benefit to this high-risk group of patients. Accordingly, the societies on both sides of the Atlantic will work together closely to update and implement these guidelines.

Publication types

  • Review

MeSH terms

  • Abciximab
  • Algorithms
  • Antibodies, Monoclonal / therapeutic use
  • Clinical Trials as Topic
  • Coronary Disease* / diagnosis
  • Coronary Disease* / drug therapy
  • Electrocardiography*
  • Europe
  • Humans
  • Immunoglobulin Fab Fragments / therapeutic use
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Practice Guidelines as Topic*
  • Risk Factors
  • Tirofiban
  • Troponin / metabolism
  • Tyrosine / analogs & derivatives*
  • Tyrosine / therapeutic use
  • United States


  • Antibodies, Monoclonal
  • Immunoglobulin Fab Fragments
  • Platelet Aggregation Inhibitors
  • Troponin
  • Tyrosine
  • Tirofiban
  • Abciximab