High risk features and markers of patients with non-ST elevation ACS
CABG, coronary artery bypass graft; CRP, C reactive protein, IL, interleukin; LV, left ventricular; MI, myocardial infarction; NT pro BNP, N terminal pro brain type natriuretic peptide. |
▸ High risk features in the early triage of patients |
Continued or recurrent ischaemia at rest |
Ischaemia complicated by cardiac failure, arrhythmia or mechanical complications |
Ischaemia with ST segment depression and/or troponin elevation |
Dynamic ST changes |
▸ Markers of pre-existing longer term risk |
Age |
Prior MI, CABG, diabetes, congestive heart failure, or hypertension |
Biological markers of renal dysfunction (raised creatinine or reduced creatinine clearance) |
Elevated inflammatory markers (high sensitivity CRP, IL-6, CD40L) |
▸ LV dysfunction |
Invasive or non-invasive markers of LV dysfunction or mechanical complication |
Biological markers of LV dysfunction (NT pro BNP) |
Extent of coronary artery disease on angiography |