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Critical review of unstable angina and non-ST elevation myocardial infarction

Northern General Hospital, Sheffield, UK

Correspondence to:
Correspondence to:
Dr Paul J Sheridan, Division of Clinical Sciences, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK;
P.J.Sheridan{at}Sheffield.ac.uk

Within the coronary vasculature the progression of a stable atherosclerotic plaque into a vulnerable and ultimately unstable lesion leads to a cascade of events culminating in the clinical presentation of unstable angina or acute myocardial infarction. In recent years studies have provided new insights in to the pathology and natural history, stimulating advances in diagnosis, treatment, and management. The review discusses the progress made including the role of inflammation, cardiac biomarkers, antiplatelet therapy, and percutaneous intervention. Current issues of debate and future directions are also addressed.

Keywords: myocardial infarction; unstable angina

Abbreviations: ACC/AHA, American College of Cardiology/American Heart Association; BSC, British Cardiac Society; CK-MB, isoenzyme of creatine kinase; ESC, European Society of Cardiology; LMWH, low molecular weight heparins; MMP, matrix metalloproteinases; NSTEMI, non-ST elevation myocardial infarction; ST elevation myocardial infarction, STEMI; VSMC, vascular smooth muscle cells