Acute Coronary Syndrome Update (Recorded at Pri-Med Midwest)
The epidemiology of acute coronary syndromes has changed dramatically in the past few decades, with lower overall incidence of myocardial infarction (MI) -- particularly ST elevation MI -- and improved survival after an incident MI. The diagnosis and classification of MI is challenging, particularly in the era of sensitive troponin assays. Clinicians must be aware of the frequent occurrence and causes of troponin elevations from conditions other than MI. Following diagnosis, risk stratification for patients with non-ST elevation ACS is critical to making prudent decisions and selecting among the multitude of different options for invasive and medical therapies. When considering potent antiplatelet and antithrombotic therapies, it is of paramount importance to also consider bleeding risk. Primary care clinicians play a critical role in determining the optimal duration of dual antiplatelet therapy, ensuring appropriate use and adherence to evidence-based medical therapies, and addressing lifestyle factors that can help prevent or modify the course after an ACS event.
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