New strategies in the management of acute coronary syndromes

Advances in the understanding of acute coronary syndromes have occurred rap idly 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 ha ve created a new world of therapeutic options for the spectrum of ischemic heart disease. As more options become available, nurses are under increasin g pressure to stay abreast of what these options have to offer patients, an d which patients benefit most from each therapeutic approach. The purpose o f this article is to review the newest therapies for acute coronary syndrom es, including GP IIb/IIIa inhibitors, low molecular weight heparins, and di rect thrombin inhibitors, and discuss indications and contraindications for each of these therapies. Changes in diagnostic approach using troponin T a nd I are also presented.