Recent research has led to new recommendations for
the optimal evaluation and treatment of patients with
UA/NSTEMI. In general, once a patient is diagnosed, a risk
assessment should be performed to determine the course
of treatment. Pharmacological intervention includes antiischemic,
antiplatelet, and anticoagulant options. Use of
an early invasive option might provide more favorable
clinical outcomes in patients considered high risk. Use of
aspirin should start early and continue indefinitely. Clopidogrel
is also recommended for early initiation in combination
with aspirin for a period of up to 12 months. The
use of enoxaparin for anticoagulation is preferred to UFH.
In high-risk patients managed conservatively, GP IIb/IIIa
antagonists (eptifibatide and tirofiban only) are recommended.
Patients should also receive early and aggressive
treatment of dyslipidemia.