The other reason postulated by many medical practitioners behind the nonconcordance with the guideline is that they did not believe that the patients were at high enough risk. Patients who underwent catheterization had lower in-hospital and one-year mortality rates compared with those who did not ( Table 1). A new study ( 6) has found that cardiac catheterization is not being used optimally in NSTE ACS patients, mainly because doctors are not risk-stratifying these patients correctly. Despite these recommendations, some contemporary registry data suggest that more aggressive therapy is not necessarily targeted in higher risk patients. Therefore, early risk stratification plays an important role in the optimal management of non-ST elevation (NSTE) acute coronary syndrom (ACS) ( 3).Ĭurrent guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) ( 3, 4) and the European Society of Cardiology (ESC) ( 5) recommend that certain pharmacological and interventional strategies are most appropriate for higher-risk patients in the NSTE ACS group. Estimated risk, based on clinical characteristics, is challenging and imprecise, yet risk assessment is needed to guide triage and key management decisions. Knowing the poor survival rate in the high-risk patients, giving the right treatment becomes imperative. ![]() The World Health Organization expects heart disease to be the number one cause of death in developing countries by 2010 ( 1, 2). Despite therapeutic advances, cardiovascular disease remains the leading cause of death worldwide ( 1, 2).
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