ABSTRACT
Non-ST elevation acute coronary syndrome (NSTE-ACS) comprises a very heterogeneous group of patients with high and durable risk of developing adverse cardiovascular events. Individual (and dynamic) risk stratifi cation based on evaluation of both ischemic and bleeding hazard is mandatory to select the most appropriate pharmacologic and interventional treatment. Recently, a general consensus has been achieved toward an early invasive strategy (i.e., angiography and revascularization when feasible and appropriate) in moderate and high-risk patients, and conservative management and subsequent further risk stratifi cation only in very low-risk patients. Several antithrombotic drugs are recommended by current guidelines. The number of available antiplatelet and anticoagulant drugs, multiple administration routes, and different timing for administration generates a huge spectrum of possible pharmacological combinations. This chapter reviews current guidelines and possible integration derived by most recent clinical trials, in an attempt to provide an evidence-based algorithm of treatment for patients with NSTE-ACS.
