Guidelines for the acute coronary syndromes.

Traditional measures employed in the immediate management of patients presenting with an acute coronary syndrome have markedly reduced the risk of early death or myocardial infarction. Further incremental benefit is seen with the substitution of enoxaparin for unfractionated heparin, and in the use of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention. However, the evidence for benefit from the glycoprotwin IIb/IIIa inhibitors with medical management alone is unconvincing. Newer data also suggest an aggressive approach to the high-risk patient offers a better ultimate outcome than a conservative one.