New strategies in the management of acute coronary syndromes

Advances in the understanding of acute coronary syndromes have occurred rapidly in the last 5 years and have dramatically changed the way patients are evaluated, diagnosed, and managed. Medical advances, such as antiplatelet and antithrombin agents and growing databases on interventional outcomes have created a new world of therapeutic options for the spectrum of ischemic heart disease. As more options become available, nurses are under increasing pressure to stay abreast of what these options have to offer patients, and which patients benefit most from each therapeutic approach. The purpose of this article is to review the newest therapies for acute coronary syndromes, including GP IIb/IIIa inhibitors, low molecular weight heparins, and direct thrombin inhibitors, and discuss indications and contraindications for each of these therapies. Changes in diagnostic approach using troponin T and I are also presented.