May 2002 Br J Cardiol 2002;9:251-4
Elliot J Smith, Nicholas P Curzen
The prognosis for patients with non-ST elevation acute coronary syndromes (ACS) is not benign. Ongoing ischaemia is only one determinant of risk. The presence of ST-segment depression or elevated level of troponins is known to identify a group of patients at high risk of further events (death, MI, re-admission with ACS).The key management issue, however, is regarding which of these patients require early (i.e. in-hospital) revascularisation. Based upon current evidence from studies including FRISC II, TIMI-18, and the recent re-analysis of TIMI-III, our current strategy is to offer invasive investigation and revascularisation to all patients identified as ‘high risk’.
April 2002 Br J Cardiol 2002;9:233-40
Is it time to forget about diastolic blood pressure? Should we abandon the mercury sphygmomanometer? Is non-pharmacological intervention a waste of time? These were some of the questions discussed at the first Primary Care Cardiovascular Society (PCCS) meeting of 2002 which was carried out jointly with the British Hypertension Society (BHS) on 26th February.
April 2002 Br J Cardiol 2002;9:195-7
Paul Collinson, Peter Stubbs
When is an infarct not an infarct? When it is an infarctlet, a necroset or a troponinosis.1 The advent of the cardiac-specific troponins as diagnostic tests has created confusion in the minds of some cardiologists. The fact that cardiac troponins may be used to diagnose previously unsuspected myocardial damage in patients presenting with acute coronary syndromes, when acute myocardial infarction (AMI) has been ruled out by conventional World Health Organization criteria, has been amply demonstrated since the original report by Hamm et al.