%0 Journal Article
%T NSTEMI treatment: should we always follow the guidelines?
%A A. W. J. van ¡¯t Hof
%A E. Badings
%J Archive of "Netherlands Heart Journal".
%D 2019
%R 10.1007/s12471-019-1244-3
%X Non-ST elevation myocardial infarction (NSTEMI) has been diagnosed more often in recent years, not only since the introduction of high-sensitive troponin assays, but also because of the ageing population. The outcome is rather good in the short term; however, in the long term the outcome is poor due to the high incidence of co-morbidities such as renal failure, diabetes and hypertension. The diagnosis of NSTEMI is rather difficult. During the 2018 ESC meeting an update of the universal definition of MI was presented [1]. A diagnosis of NSTEMI can only be made if acute myocardial injury (defined as a rise and/or fall of cardiac troponin (cTn) above the 99th percentile upper reference limit (URL)) is present in combination with acute myocardial ischaemia. Type 1 MI is caused by atherosclerosis (plaque rupture or erosion), whereas type 2 MI is the result of an imbalance between oxygen demand and supply (hypertension, anaemia or tachycardia) (Fig. 1). Only patients with type I MI might benefit from early angiography and/or revascularisation; however, in daily practice it is not easy to discriminate between type 1 and type 2 MI
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439087/