Diagnosing and managing unstable angina. Agency for Health Care Policy and Research.

This Quick Reference Guide for Clinicians contains recommendations on the care of patients with unstable angina based on a combination of evidence obtained through extensive literature reviews and consensus among members of an expert panel. Principal conclusions include the following. (1) Many patients suspected of having unstable angina can be discharged home after adequate initial evaluation. (2) Further outpatient evaluation may be scheduled for up to 72 hours after initial presentation for patients with clinical symptoms of unstable angina judged at initial evaluation to be at low risk for complications. (3) Patients with acute ischemic heart disease judged to be at intermediate or high risk of complications should be hospitalized for careful monitoring of their clinical course. (4) Intravenous thrombolytic therapy should not be

[1]  S. Scott,et al.  Comparison of medical and surgical treatment for unstable angina pectoris. Results of a Veterans Administration Cooperative Study. , 1987, The New England journal of medicine.

[2]  D. Williams,et al.  Anticoagulant treatment in unstable angina , 1986, The British journal of clinical practice.

[3]  R. Kronmal,et al.  Determinants of operative mortality and long-term survival in patients with unstable angina. The CASS experience. , 1985, The Journal of thoracic and cardiovascular surgery.

[4]  R. Rosati,et al.  Unstable angina pectoris: National Cooperative Study Group to Compare Surgical and Medical Therapy. , 1976, The American journal of cardiology.

[5]  L. Bolognese,et al.  RANDOMISED TRIAL OF INTRAVENOUS STREPTOKINASE, ORAL ASPIRIN, BOTH, OR NEITHER AMONG 17 187 CASES OF SUSPECTED ACUTE MYOCARDIAL INFARCTION: ISIS-2 , 1988, The Lancet.

[6]  Robert Califf,et al.  Value of the History and Physical in Identifying Patients at Increased Risk for Coronary Artery Disease , 1993, Annals of Internal Medicine.

[7]  J. Wittes,et al.  Overview of results of randomized clinical trials in heart disease. II. Unstable angina, heart failure, primary prevention with aspirin, and risk factor modification. , 1988, JAMA.

[8]  E. Cook,et al.  Clinical characteristics and outcome of acute myocardial infarction in patients with initially normal or nonspecific electrocardiograms (a report from the Multicenter Chest Pain Study). , 1989, The American journal of cardiology.

[9]  S. Khuri,et al.  Coronary bypass surgery improves survival in high-risk unstable angina. Results of a Veterans Administration Cooperative study with an 8-year follow-up. Veterans Administration Unstable Angina Cooperative Study Group. , 1991, Circulation.

[10]  M. LeWinter,et al.  Protective effects of aspirin against acute myocardial infarction and death in men with unstable angina. Results of a Veterans Administration Cooperative Study. , 1983, The New England journal of medicine.

[11]  C. Furberg,et al.  Calcium channel blockers in acute myocardial infarction and unstable angina: an overview. , 1989, BMJ.

[12]  The Risc Group Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease , 1990, The Lancet.

[13]  S. Scott,et al.  Veterans Administration Cooperative Study for treatment of patients with unstable angina. Results in patients with abnormal left ventricular function. , 1988, Circulation.

[14]  Joy,et al.  Coronary angioplasty versus coronary artery bypass surgery: the Randomized Intervention Treatment of Angina (RITA) trial. , 1993, Lancet.

[15]  P. Théroux,et al.  Aspirin, heparin, or both to treat acute unstable angina. , 1988, The New England journal of medicine.

[16]  D. Sackett,et al.  Aspirin, sulfinpyrazone, or both in unstable angina. Results of a Canadian multicenter trial. , 1985, The New England journal of medicine.

[17]  A. Telford,et al.  TRIAL OF HEPARIN VERSUS ATENOLOL IN PREVENTION OF MYOCARDIAL INFARCTION IN INTERMEDIATE CORONARY SYNDROME , 1981, The Lancet.

[18]  S. Khuri,et al.  Medical compared with surgical management of unstable angina. 5-year mortality and morbidity in the Veterans Administration Study. , 1989, Circulation.

[19]  D. Waters,et al.  A randomized study comparing propranolol and diltiazem in the treatment of unstable angina. , 1985, Journal of the American College of Cardiology.

[20]  F. Harrell,et al.  Continuing evolution of therapy for coronary artery disease. Initial results from the era of coronary angioplasty. , 1994, Circulation.

[21]  D. Waters,et al.  Aspirin Versus Heparin to Prevent Myocardial Infarction During the Acute Phase of Unstable Angina , 1993, Circulation.

[22]  L. Wallentin,et al.  Aspirin (75 mg/day) after an episode of unstable coronary artery disease: long-term effects on the risk for myocardial infarction, occurrence of severe angina and the need for revascularization. Research Group on Instability in Coronary Artery Disease in Southeast Sweden. , 1991, Journal of the American College of Cardiology.

[23]  Harry P. Selker,et al.  A Tool for Judging Coronary Care Unit Admission Appropriateness, Valid for Both Real-Time and Retrospective Use: A Time-Insensitive Predictive Instrument (TIPI) for Acute Cardiac Ischemia: A Multicenter Study , 1991, Medical care.

[24]  P. Hartigan,et al.  A Comparison of Angioplasty With Medical Therapy in the Treatment of Single-Vessel Coronary Artery Disease , 1992 .

[25]  J. Lubsen,et al.  Efficacy of nifedipine and metoprolol in the early treatment of unstable angina in the coronary care unit: findings from the Holland Interuniversity Nifedipine/metoprolol Trial (HINT). , 1987, The American journal of cardiology.

[26]  B. Rosner,et al.  Nifedipine and conventional therapy for unstable angina pectoris: a randomized, double-blind comparison. , 1984, Circulation.

[27]  F. Harrell,et al.  Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. , 1991, The New England journal of medicine.

[28]  E F Cook,et al.  Acute chest pain in the emergency room. Identification and examination of low-risk patients. , 1985, Archives of internal medicine.