3.2 Medically Managed ACS - Dr. Hairudi Sp.jp (Slide)
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Transcript of 3.2 Medically Managed ACS - Dr. Hairudi Sp.jp (Slide)
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Hairudi Sugijo, dr, Sp.JP-FIHA
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EDUCATION1980-1987 Medical, Airlangga University, Surabaya (M.D.)1995-2001 Residency (Cardiology), Airlangga University, Surabaya
2012-present Post-graduate Programme, Brawijaya University, MalangMEDICAL SOCIETIES2001-present Member, IHA2009-present Member, HFA-ESC2014-present Fellow, ASEAN College Of CardiologyHOSPITAL APPOINTMENTS
2001-present Cardiologist, Sidoarjo General Hospital, Sidoarjo
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Hairudi Sugijo, MD
Medically ManagedPatients with
Acute Coronary Syndrome
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Ischemic Chestpain
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Acute Coronary Syndrome (ACS)
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Management of UA/NSTE-ACS
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Risk stratification in UA/ NST-ACS
• High Risk Markers (Early Invasive Strategy) – Elevated troponins – Recurrent angina/ischemia at rest or with low level activities – New or presumably new ST segment depression – Recurrent angina/ischemia with CHF, S 3 gallop, rales, MR – High risk findings on noninvasive stress testing – Depressed LVF (EF
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UA / NST-ACS
JACC. September 23, 2014. Accepted Manuscript
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JACC. September 23, 2014. Accepted Manuscript
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Management of STE-ACS
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Take Home message
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STEMI
Aspirin Yes
Non-STEMI/UnstableAngina
YesClopidogrel Yes Yes
Heparin Yes
IIb/IIIa antagonists
Yes
10 PCI – NotPa (thrombolytic agent) No
Beta Blockers Yes YesYes YesACE Inhibitors/ARB
Aldosterone Antagonists Yes YesLVDysfunction
Statins Yes Yes
PCI – Yes10 PCI – Yes
Medication/Intervention
No PCI – Yes
No PCI – No No PCI – High Riskonly -Yes
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Personalized Medicine refers to the tailoring of medicaltreatment to the individual characteristics of each patient
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Risk Score for UA/ NST-ACS
