Chinese Society of Cardiovascular Diseases Chinese Journal of Cardiovascular Diseases Editorial BoardÂ
In recent years, the understanding of the pathophysiological mechanisms of unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI) has been gradually deepened, and the results of large-scale clinical trials have been released one after another, and important progress has been made in their clinical treatment. In order to better summarize these experiences and reasonably guide clinical practice, the Editorial Committee of the Chinese Society of Cardiovascular Diseases and the Chinese Journal of Cardiovascular Diseases, based on the research results of relevant clinical trials in recent years, refer to the relevant guidelines of the American College of Cardiology (ACC)/American Heart Association (AHA) and the European Society of Cardiology (ESC), and combined with the specific situation of cardiovascular disease prevention and treatment in China, organized relevant It is believed that it will play an important guiding role in improving the comprehensive prevention and treatment of UA and NSTEMI in China and promoting the standardization process of clinical practice. Jiang Weidong, Department of Cardiovascular Medicine, Nantong Hospital of Traditional Chinese Medicine
In order to facilitate the reader’s understanding of the value or significance of a diagnostic procedure or treatment, the recommendations for indications in this guideline are expressed in an internationally accepted manner as follows:
Category I:An operation or treatment that has been proven and/or unanimously recognized as beneficial, useful, and effective.
Category II:Evidence of the usefulness and effectiveness of a diagnostic or therapeutic measure is conflicting or there are differing views.
Category IIa:The relevant evidence and/or opinion favors usefulness and/or effectiveness.
Category IIb:The evidence and/or views do not yet adequately demonstrate usefulness and/or effectiveness.
Category III:It has been proven and/or unanimously accepted that a treatment measure is useless and ineffective and may be harmful in some cases and is not recommended.
The levels of evidence sources were expressed as follows:
Level of evidence A: Information derived from multiple randomized clinical trials or pooled analyses.
Level of evidence B: information derived from a single randomized trial or multiple non-randomized trials.
Level of evidence C: expert consensus and/or small trial results.
I. Acute coronary syndrome (ACS)
ACS is a large group of clinical syndromes containing different clinical features, clinical risk and prognosis, which share a common pathological mechanism, i.e., rupture of coronary atherosclerotic plaque, thrombosis, and leading to different degrees of obstruction of the diseased vessel. According to the presence or absence of persistent ST-segment elevation on ECG, ACS can be distinguished into two major categories: ST-segment elevation myocardial infarction (mostly Q-wave myocardial infarction and a few non-Q-wave myocardial infarction), and the latter including unstable angina and NSTEMI, which are mostly non-Q-wave myocardial infarction and a few Q-wave myocardial infarction (Figure 1).
Non-ST-segment elevation
of myocardial infarction