If an initial conservative strategy is selected, it may be reasonable to add eptifibatide or tirofiban to anticoagulant and oral antiplatelet therapy.19,20 (Level B)
Prasugrel may be considered for administration promptly upon presentation if PCI is planned, before definition of coronary anatomy if both the risk for bleeding is low and the need for CABG is considered unlikely. (Level C)
The use of GP IIb/IIIa inhibitors may be considered in high-risk patients already receiving ASA and a thienopyridine who are selected for an invasive strategy, such as those with elevated troponin levels, diabetes, or significant ST-segment depression, and who are not otherwise at high risk for
bleeding. (Level B)
In patients with definite UA/NSTEMI undergoing PCI, the use of a loading dose of clopidogrel of 600mg, followed by a higher maintenance dose of 150mg daily for 6 days, then 75mg daily may be reasonable in patients not considered at high risk for bleeding. (Level B)
Abciximab should not be administered to patients in whom PCI is not planned. (Level A)
Low risk patients for ischemic events (TIMI risk score 2) or at high risk of bleeding and who are already receiving ASA and clopidogrel, upstream GP IIb/IIIa inhibitors are not recommended. (Level B)
Unstable Angina - NSTEMI Guidelines
ACS - Risk Stratification
Harbor Macros: EKG
ACS - Stress Testing
Maine:Prehospital protocol pediatric shock
Harbor Macros: Chest Pain
Maine:Prehospital protocol pediatric stridor
ECGs by Diagnosis