Medicamentous management of acute coronary syndrome without ST segment elevation

Recent advances in the recognition and the treatment of acute coronary syndromes (ACS) have lead to an improvement in patient survival and definition of newer guidelines. Current strategies for the treatment of patients with non-ST-elevation ACS include anti-ischemic and antiplatelet medications. While aspirin, beta-blockers, heparin and nitrates are still common practice, the advent of newer anticoagulants (low molecular weight heparins) and antiplatelet agents (glycoprotein llb/IIIa inhibitors and thienopyridines like ticlopidin and clopidogrel) and, possibly, aggressive lipid lowering with statins have added significant benefits to the treatment options with a better prognosis for these patients. Moreover, aggressive medical strategies seem to be justified not only in high-risk patients but also in those that undergo an early invasive approach.