ABSTRACT
Scope of the clinical problem The management of acute coronary syndrome (ACS), defined as unstable angina or acute myocardial infarction (AMI), presents a major challenge to clinicians because of the frequency and clinical importance of these events. In the USA alone there are an estimated 1.5 million hospital admissions each year for ACS —divided approximately equally between unstable angina and AMI1-and the problem is of similar magnitude in other Western countries. Despite recent advances in medical and interventional therapy, ACS carries a high risk of early recurrent ischemic events. For example, after presentation with a non-ST segment elevation ACS, the six-month risk of death or recurrent non-fatal AMI is approximately 10% and the risk of death, AMI, or recurrent unstable ischemia is approximately 20%.2-5 Thus, our challenge, both as investigators and as practitioners, is to identify and employ new treatments that will help to reduce the incidence and improve the outcomes of ACS.
