PROGRESS IN THE DIAGNOSIS OF UNSTABLE ANGINA AND PERSPECTIVES FOR TREATMENT

Unstable angina is a high-risk phase of coronary heart disease defined by clinical symptoms. Electrocardiographic findings are heterogeneous and creatine kinase is only rarely elevated. However, troponin T and troponin I are found in about 30-40% of patients with angina at rest d isclosing minor myocardial cell injury. Several studies in recent year s have documented that troponins are the best markers to identify high -risk patients when other life-threatening, noncardiac diseases are ex cluded. In addition, first evidence is provided that only these patien ts benefit from prolonged treatment with low molecular weight heparin or glycoprotein IIb/IIIa receptor blockers. Therefore, this new diagno stic potential should be made available to emergency rooms for risk st ratification and in the future to guide therapeutic decision making.