Time-honored treatments for the initial management of acute coronary syndromes: Challenging the status quo |
| |
| Authors: | Cian P. McCarthy Eoin Donnellan Jason H. Wasfy Deepak L. Bhatt John W. McEvoy |
| |
| Affiliation: | 1. Department of Medicine, Massachusetts General Hospital, Boston, MA;2. Department of Medicine, Cleveland Clinic, Cleveland, OH;3. Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA;4. Brigham and Women’s Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA;5. Johns Hopkins Coronary Care Unit and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD |
| |
| Abstract: | Morphine, oxygen, and nitrates are time-honored therapies for the initial management of acute coronary syndrome (ACS). The traditional goal of these agents in ACS has been to (1) relieve symptoms, (2) prevent infarction or limit its size, and (3) improve outcomes, both acutely and during follow-up. Despite their ongoing use in routine ACS care, nitrates, morphine, and oxygen have no evidence of clinical outcomes benefit from randomized trials. Furthermore, emerging data have recently suggested that, in certain situations, morphine and oxygen may actually be associated with harm in the setting of ACS. In this review article, we thoroughly examine updated evidence for each of these acute-phase ACS agents with respect to their individual risks and benefits. We review guideline recommendations for these therapies and outline future directions for their use in clinical practice. |
| |
| Keywords: | Morphine Oxygen Nitrates |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
