The Year in Non–ST-Segment Elevation Acute Coronary Syndrome

A new risk score system for the assessment of clinical outcomes in patients with non-ST-segment elevation myocardial infarction

“…Elevated serum creatinine level is a powerful indicator of the primary endpoint in our database, as well. A recent study suggested that early invasive therapy provided therapeutic benefits even in patients with moderate to severe chronic kidney disease [24].…”

The Year in Non–ST-Segment Elevation Acute Coronary Syndrome

“…Newer research on neopterin and heart-type fatty acidbinding protein have built on previous results described in our 2009 publication (30). In the PROVE IT-TIMI 22 trial in post-ACS patients, neopterin, a marker of monocyte activation, was found to be an independent predictor of subsequent hospitalization for heart failure, and it improved risk prediction when it was added to models including traditional risk factors, high-sensitivity C-reactive protein (hsCRP), and BNP in patients post-ACS enrolled in the PROVE IT-TIMI 22 trial (31).…”

“…Furthermore, in a meta-analysis of 8 studies of 48,599 patients undergoing PCI (regardless of genotype) comparing one of the newer more potent PGY 12 inhibitors with clopidogrel, the newer agents reduced mortality (OR: 0. 85 [55]), ticagrelor was as effective at reducing the primary composite of cardiovascular death, MI, and stroke as it was in the trial overall (HR: 0.84). Thus, there seems to be a benefit that exists outside of the peri-PCI period as well.…”

Beyond Aspirin and Clopidogrel: Is There a Need for Additional Antiplatelet Therapy in ACS?

“…Prasugrel was also more attractive from a cost-effectiveness perspective, where total costs were on average $221 lower per patient with prasugrel compared with proprietary clopidogrel, largely due to a decrease in the number of hospital readmissions and repeat revascularization procedures [31,32]. Overall, the data with prasugrel prompted revisions in the antiplatelet therapy recommendations in a 2009 Focused Guideline Update on PCI [33•] in which treatment with clopidogrel or prasugrel for 12 months is a Class 1 indication for patients with ACS undergoing bare-metal or drug-eluting stent (DES) placement.…”