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Determining the risk of rapid disease progression in acute coronary syndrome without ST segment elevation

The importance of dividing patients with unstable angina and myocardial infarction without ST segment elevation into high and low risk groups for complications is justified by the fact that the clear advantage of performing early coronary angiography and, if necessary, percutaneous coronary intervention is determined only in patients at high risk for complications.

The recommendations of the European Society of Cardiology for the treatment of acute coronary syndrome without ST elevation give characteristics of patients at high risk for a sharp progression of the disease with subsequent development of MI or death. Coronary angiography in these patients should be performed within the first 48 hours. The characteristics of patients belonging to the high risk group for the development of acute thrombotic complications of acute coronary syndrome without ST elevation are as follows:

• Repeated bouts of angina pectoris

• Dynamic ST segment changes

• Elevated levels of troponins

• Hemodynamic instability

• Severe arrhythmias (ventricular)

• Early post-infarction angina

• Diabetes.

In addition, when assessing the risk of possible complications of acute coronary syndrome without ST elevation, it is necessary to take into account the concomitant markers that affect the development of complications in the long term of the disease.
These markers include:

• Age> 65-70 years

• The presence of symptoms of coronary heart disease, previous heart attacks, percutaneous coronary intervention and a history of CABG

• Severe heart failure, pulmonary edema, noises that appear, characteristic for mitral valve insufficiency

• Growth of markers of inflammation (CRP, fibrinogen, interleukin-6)

• Renal failure.

An analysis of the TACTICS — TIMI 18 study by post hoc (retrospective) showed that early invasive treatment of elderly patients with acute coronary syndrome without ST elevation significantly reduces the severity of myocardial ischemia.
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Determining the risk of rapid disease progression in acute coronary syndrome without ST segment elevation

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    395-5396-4397-4398-599-3-400-5-401-2402-5403-5404-1405-2406-5407-5408-4409-3,410-3,411-3 3 412- 3 413- 4 414- 5 415- 4 416- 4 417- 2 418-
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