Síndrome coronario agudo sin elevación del segmento ST

  1. Abellas Sequeiros, M. 1
  2. García Sebastián, C. 1
  3. Zamorano Gómez, J.L. 1
  1. 1 Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, España
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2021

Título del ejemplar: Enfermedades cardiovasculares (IV)

Serie: 13

Número: 38

Páginas: 2171-2176

Tipo: Artículo

DOI: 10.1016/J.MED.2021.07.001 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

El síndrome coronario agudo sin elevación del segmento ST (SCASEST) es un cuadro provocado por una necrosis miocárdica, cuya manifestación clínica primordial es el dolor torácico. El diagnóstico de esta entidad requiere un estudio completo del paciente, incluyendo historia clínica, exploración física, electrocardiograma, ecocardiograma y analítica con marcadores de lesión miocárdica (troponina). El tratamiento en la fase aguda se sustenta en dos pilares fundamentales: antiagregación y revascularización. Posteriormente, será vital una adecuada estrategia de seguimiento y prevención secundaria.

Referencias bibliográficas

  • Collet J.P, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42(14):1289-367
  • Theroux P. Acute coronary syndromes: a companion to Braunwald’s heart disease. New York: Saunders; 2003.
  • Campeau L. Letter: Grading of angina pectoris. Circulation. 1976;54(3): 522-3.
  • Fox KAA, Dabbous OH, Goldberg RJ, Pieper KS, Eagle KA, Van de Werf F. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 2006;333(7578):1091.
  • Chew DP, Astley CM, Luker H, Alprandi Costa B, Hillis G, Chow CK. A cluster randomized trial of objective risk assessment versus stan-dard care for acute coronary syndromes: Rationale and design of the Aus-tralian GRACE Risk score Intervention Study (AGRIS). Am Heart J. 2015;170(5):995-1004.e1.
  • Subherwal S, Bach RG, Chen AY, Gage BF, Rao SV, Newby LK. Baseline risk of major bleeding in non–ST segment elevation myocardial infarction: The CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) Bleeding Score. Circulation. 2009;119(14):1873-82.
  • Mehran R, Pocock SJ, Nikolsky E, Clayton T, Dangas GD, Kirtane AJ. A risk score to predict bleeding in patients with acute coronary syndromes. Journal of the Am Coll Cardiol. 2010;55(23):2556-66.
  • Neumann JT, Twerenbold R, Ojeda F, Sörensen NA, Chapman AR, Shah ASV. Application of high-sensitivity troponin in suspected myocardial infarction. N Engl J Med. 2019;380(26):2529-40.
  • Boeddinghaus J, Twerenbold R, Nestelberger T, Koechlin L, Wussler D, Meier M. Clinical use of a new high sensitivity cardiac troponin I assay in patients with suspected myocardial infarction. Clin Chem. 2019;65(11):1426-36.
  • Samad Z, Hakeem A, Mahmood SS, Pieper K, Patel MR, Simel DL. A meta analysis and systematic review of computed tomography angiography as a diagnostic triage tool for patients with chest pain presenting to the emergency department. J Nucl Cardiol. 2012;19(2):364-76.
  • Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373(9678):1849-60.
  • Montalescot G, Bolognese L, Dudek D, Goldstein P, Hamm C, Tanguay JF. Pretreatment with prasugrel in non–ST segment elevation acute coronary syndromes. N Engl J Med. 2013;369(11):999-1010.
  • Schüpke S, Neumann FJ, Menichelli M, Mayer K, Bernlochner I, Wöhrle J. Ticagrelor or prasugrel in patients with acute coronary syndromes. N Engl J Med. 2019;381(16):1524-34.
  • Kofoed KF, Kelbæk H, Hansen PR, Torp Pedersen C, Høfsten D, Kløvgaard L. Early versus standard care invasive examination and treatment of patients with non-ST segment elevation acute coronary syndrome: VERDICT Randomized Controlled Trial. Circulation. 2018;138(24):2741-50.
  • Mehta SR, Granger CB, Boden WE, Steg PG, Bassand JP, Faxon DP. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med. 2009;360(21):2165-75.
  • Head SJ, Davierwala PM, Serruys PW, Redwood SR, Colombo A, Mack MJ. Coronary artery bypass grafting vs. percutaneous coronary intervention for patients with three-vessel disease: final five year follow-up of the SYNTAX trial. Eur Heart J. 2014;35(40): 2821-30.
  • Morice MC, Serruys PW, Kappetein AP, Feldman TE, Ståhle E, Colombo A. Five year outcomes in patients with left main disease treated with either percutaneous coronary intervention or coronary artery bypass grafting in the synergy between percutaneous coronary intervention with taxus and cardiac surgery trial. Circulation. 2014;129(23):2388-94.
  • Neumann FJ, Sousa Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U. 2018 ESC/EACTS Guidelines on myocardial revasculari-zation. Eur Heart J. 2019;40(2):87-165.