November 2007, Volume 37 Number 11 , p 33 - 34 [FREE]



function openWeblink(url,target,width) { if (!width) width = '100%'; var newWindow; newWindow =,target,'width='+width+',height=480,status,resizable,titlebar,toolbar,scrollbars'); newWindow.focus(); } function set_JnlFullText_Print() { metaTag = document.createElement('meta'); metaTag.setAttribute('name','OvidPageId'); metaTag.setAttribute('content','JnlFullText_Print'); head = document.getElementsByTagName('head')[0]; head.appendChild(metaTag); return; } if (window.addEventListener) { // DOM Level 2 Event Module (NS 6+) window.addEventListener('onload',set_JnlFullText_Print(),false); } else if (window.attachEvent) { // IE 5+ Event Model window.attachEvent('onload',set_JnlFullText_Print); } // For anything else, just don't add the event Full Text   #header-block { display: none; } © 2007 Lippincott Williams & Wilkins, Inc. Volume 37(11), November 2007, p 33–34 A new slant on unstable angina [Feature: CLINICAL ROUNDS: NEWS, UPDATES, RESEARCH: ...


Revised guidelines for patients with unstable angina and non-ST-elevation myocardial infarction (NSTEMI) have been issued by the American College of Cardiology (ACC) and American Heart Association (AHA). This updates ACC/AHA guidelines published in 2002.


Among other changes, the new guidelines recommend:


* an initial set of noninvasive tests (for example, a stress test and echocardiogram) for people with these conditions who are stabilized or low risk, as determined by a set of risk scores. The 2002 guidelines recommended diagnostic angiography and revascularization for all patients.


* use of the antiplatelet drug clopidogrel for at least 1 year after a patient receives a drug-eluting stent


* more aggressive lipid and blood pressure (BP) control. Low-density lipoprotein should be lower than 100 mg/dL; BP should be lower than 140/90. Those with diabetes or chronic kidney disease should maintain BP below 130/80.


* discontinuing hormone replacement therapy in postmenopausal women


* discontinuing nonsteroidal anti-inflammatory drugs during the hospitalization of any patient with unstable angina or NSTEMI.



For more details on recommended diagnostic testing, drug therapies, and emergency department triage protocols, visit or