Interventional treatment of acute coronary syndrome (ACS): Non-ST elevation ACS (NSTE-ACS)

Cardiovascular disease, of which coronary artery disease (CAD) is the prevalent manifestation, is the most common cause of death for both genders in industrialized countries; women develop CAD nearly a decade later in life. Across the entire spectrum of CAD, acute coronary syndromes (ACSs), characterized by acute plaque rupture or erosion with sudden coronary blood flow impairment, are associated with the highest rates of adverse clinical events. Among ACSs, the non-ST elevation ACS (NSTE-ACS), including non-ST elevation MI (NSTEMI) or unstable angina, is more frequent than ST elevation acute myocardial infarction (STEMI). While hospital mortality is higher in patients with STEMI than among those with NSTE-ACS, at 6 months, the mortality rates are similarly high in both clinical conditions and are higher among patients with NSTE-ACS at longer-term follow-up, most likely due to the more widely heterogeneous and worse overall risk profile of patients with NSTE-ACS. These latter epidemiological data suggest the need for defining optimal acute and chronic treatment strategies for NSTE-ACS.