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The Role of Antithrombotic Therapy in the Acute Ischemic Syndromes

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Acute Coronary Care

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Abstract

The acute ischemic syndromes include unstable angina (with its subsets of new exertional angina, crescendo exertional angina, new rest angina, and crescendo rest angina), subendocardial myocardial infarction, and transmural myocardial infarction. Causes of myocardial ischemia in these syndromes include fixed coronary stenosis with myocardial oxygen demand exceeding supply, coronary vasospasm, and thrombosis of a coronary segment narrowed by atheroma or vasospasm [1–4] (see chapters 4–6). The extent to which each mechanism is operating in a particular patient or syndrome will obviously influence the efficacy of a particular therapeutic modality. The importance of thrombosis in the acute ischemic syndromes has been increasingly appreciated in recent years, with recent occlusive thrombus documented pathologically in 10% of cases of unstable angina, 35% of subendocardial infarcts, and 90% of transmural infarcts [5]. To best assess methods of intervention and the design of clinical trials, the process of arterial thrombosis is discussed below in the context of antithrombotic therapy.

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Authors
  1. Shaun Coughlin
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  2. Lewis T. Williams
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Editors and Affiliations

  1. Department of Medicine, Duke University Medical Center, Box 31123, 27710, Durham, North Carolina, USA

    Robert M. Califf M.D.

  2. Department of Medicine, Duke University Medical Center, Box 31211, 27710, Durham, North Carolina, USA

    Galen S. Wagner M.D.

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© 1985 Martinus Nijhoff Publishing, Boston/Dordrecht/Lancaster

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Coughlin, S., Williams, L.T. (1985). The Role of Antithrombotic Therapy in the Acute Ischemic Syndromes. In: Califf, R.M., Wagner, G.S. (eds) Acute Coronary Care. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3828-4_16

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  • DOI: https://doi.org/10.1007/978-1-4613-3828-4_16

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