ABSTRACT
Acute coronary syndrome (ACS) encompasses a spectrum of ischaemic conditions typically related to plaque rupture or erosion with subsequent thrombus formation and partial or complete coronary occlusion. This chapter describes practical aspects of contemporary percutaneous coronary intervention (PCI) practice in unstable angina and non-ST-elevation myocardial infarction (NSTEMI). The annual incidence of NSTEMI is higher than STEMI and this trend is increasing, likely due to ongoing improvements in primary and secondary prevention. Myocardial ischaemia leads to a dynamic elevation of cardiac troponin >99th percentile of healthy individual levels. However, troponin elevation must be interpreted within the context of the patient's clinical presentation and other investigations. While pharmacological and revascularisation strategies can improve the prognosis, risks of treatment may outweigh benefit in some patients especially those at low cardiovascular risk or high bleeding risk and thus early and accurate risk stratification is required.
