![]() Such information is important to the patient and family and also allows for more effective triage and allocation of clinical resources. Risk stratification, aimed at providing a more accurate estimate of a patient’s prognosis, is pivotal in the clinical management of patients with UA-NSTEMI. This higher risk has been associated with the increased age and burden of other diseases in patients with UA and NSTEMI. In contrast, long-term risk of death or cardiovascular complications is higher in patients with UA or NSTEMI than in patients with STEMI. Short-term mortality is lower in patients with UA (1.7% at 30 days) as compared with those with NSTEMI or ST-segment elevation myocardial infarction (STEMI 5.1% at 30 days for each). Nonetheless, among patients presenting with UA-NSTEMI, there is substantial heterogeneity in the risk of death and major cardiac ischemic events over time. Thus, treatments for UA and NSTEMI are identical and consist of a combination of anti-ischemic and antithrombotic therapies, and potentially coronary revascularization. Both entities typically share a common pathobiologic basis, development of a severe but nonocclusive coronary artery thrombus superimposed on a recently disrupted vulnerable plaque. ![]() If these symptoms are accompanied by release of cardiac biomarkers of necrosis (e.g., creatine kinase MB or cardiac-specific troponin) then the diagnosis of non–ST-segment elevation myocardial infarction (NSTEMI) is made. Unstable angina (UA) is classically defined as ischemic discomfort that occurs at rest (or with minimal exertion), occurs with a crescendo pattern, or is severe and of new onset. ![]()
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