Recent clinical trials in acute coronary syndromes without persistent ST elevation

Acute coronary occlusion is a serious manifestation of coronary artery dise ase leading to significant short- and long-term morbidity and mortality. Tr aditionally classified as Q-wave myocardial infarction, non-Q-wave myocardi al infarction, and unstable angina, these events are more appropriately ter med acute coronary syndromes with and without ST-segment elevation, reflect ing the diagnostic criteria used by clinicians to guide initial treatment s trategies, Standard therapy with aspirin and heparin has been expanded with the low molecular weight heparin enoxaparin and the intravenous glycoprote in IIb/IIIa inhibitors eptifibatide and tirofiban, Debate continues as to w hether a strategy of early intervention or initial conservative management is most appropriate. Continued clinical trials will help define optimal tre atment strategies in this high-risk group Of patients. Curr Opin Cardiol 19 99, 14:403-411 (C) 1999 Lippincott Williams & Wilkins, Inc.