Core IM: Mind the Gap on Unstable Angina

March 28, 2019

CORE IM Podcast < 1 min read

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Join us for Part 2 of our who, what, why exploration of unstable angina… does it even still exist and what should we do about it? || By Steven R. Liu MD and Janine Knudsen MD ||  Peer Review Dr Norma Keller MD || Graphic Design by Gaby Mayer

For a transcript of the podcast and show notes: https://www.coreimpodcast.com/2019/03/27/unstable-angina/

Time stamps

  1. History matters – how symptoms match up to pathophysiology [2:30]
  2. Vulnerable plaque vs. progressive atherosclerosis: the same or different? [5:11]
  3. High sensitivity troponins and the future of unstable angina – should it still exist? [7:36]
  4. Risk Stratification Redux – how to determine who needs a “cath” [9:45]
  5. Review of teaching points [12:24]

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References

  • Braunwald E. Unstable angina, A classification. Circulation. 1989;80:410–414
  • Braunwald E. Unstable Angina: An Etiologic Approach to Management. Circulation. 1998; 98:2219-2222.
  • Falk E, Prediman KS, Fuster V. “Coronary Plaque Dispruption” Circulation. 1995;92:657-671.
  • Hamm CW, Braunwald E. “A classification of unstable angina revisited” Circulation. 2000;102:118-122
  • Braunwald E, Morrow DA. “Unstable Angina: Is it time for a Requiem” Circulation. 2013;127:2452-2457.
  • Wadhera, R. K., Sukul, D., Secemsky, E. A., Shen, C., Gurm, H. S., Boden, W. E., & Yeh, R. W. (2019). Temporal Trends in Unstable Angina Diagnosis Codes for Outpatient Percutaneous Coronary Interventions. JAMA internal medicine, 179(2), 259-261.
  • Cannon CP et al. “Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor Tirofiban.” N Engl J Med 2001; 344:1879-1887.
  • Amsterdam EA et al. “2014 AHA/ACC Guideline for the management of patients with non-st-elevation acute coronary syndromes” Circulation. 2014;130:e344-e426.
  • Granger CB et al. “Predictors of hospital mortality in the Global Registry of acute coronary events” Arch Intern Med. 2003;163:2345-53