Leading Christian Resource for Avid Readers, Support New Schools with Every Purchase.

Antiplatelet and Anticoagulant Treatments for Unstable Angina/Non-ST Elevation Myocardial Infarction: Comparative Effectiveness Review Number 129

Paperback |English |1494489325 | 9781494489328

Antiplatelet and Anticoagulant Treatments for Unstable Angina/Non-ST Elevation Myocardial Infarction: Comparative Effectiveness Review Number 129

Paperback |English |1494489325 | 9781494489328
Overview
Acute coronary syndrome (ACS) encompasses three similar yet distinct disorders: (1) ST–elevation myocardial infarction (STEMI), (2) non–ST elevation myocardial infarction (NSTEMI), and (3) unstable angina (UA). These disorders are often collapsed into just two categories—STEMI and UA/NSTEMI—because UA and NSTEMI have a similar pathophysiology, mortality rate, and management strategy when compared with STEMI. In the United States, approximately 1.4 million people are diagnosed with ACS each year, and 70 percent of them have UA/NSTEMI. UA/NSTEMI is defined by the presence of ischemic chest pain (or an equivalent), the notable absence of ST segment elevation on electrocardiography, and the presence of either ST segment depression or T-wave inversion on electrocardiography and/or abnormal cardiac biomarkers. The pathophysiology of UA/NSTEMI involves six possible etiologies: (1) thrombus arising from a disrupted or eroded plaque, (2) thromboembolism from an erosive plaque, (3) dynamic obstruction (such as coronary spasm), (4) progressive mechanical obstruction, (5) inflammation, or (6) coronary artery dissection. Most patients with UA/NSTEMI have thrombus formation or progressive arterial narrowing that leads to subtotal occlusion of an epicardial coronary artery. The difference between UA and NSTEMI is based on the presence of myocardial necrosis or infarction as suggested by serum tests such as creatine kinase-myocardial band, troponin I, or troponin T in NSTEMI. The standard treatment goals for patients with UA/NSTEMI involve the elimination of ischemic pain and the prevention of adverse events—death, recurrent ischemia, or myocardial infarction (MI). The cornerstone of short- and long-term treatment in all cases is medical therapy with antiplatelet and anticoagulant medications. Antiplatelet medications work by decreasing platelet aggregation and inhibiting thrombus formation. The timing of initiation of antiplatelet therapy in patients presenting with UA/NSTEMI is broadly classified as upstream if the therapy is initiated after admission but prior to cardiac catheterization or periprocedural if the agent is initiated at the time of or during the procedure. Antiplatelet therapy initiated during a hospitalization for UA/NSTEMI and continued for long-term management has been shown to reduce future cardiovascular events. Anticoagulant medications work by inhibiting blood clotting, either by antagonizing the effects of vitamin K or by blocking/inhibiting thrombin. The use of a parenteral anticoagulant, traditionally heparin, is standard treatment for patients hospitalized with ACS, and newer anticoagulants have been developed that improve outcomes, with similar or reduced bleeding risk compared with heparin. By virtue of its ability to inhibit factors associated with thrombosis and to reduce ischemic outcomes, each antiplatelet or anticoagulant agent has the potential to increase the risk of bleeding. The tradeoff between reduced ischemic risk and increased bleeding risk has been highlighted in a number of recent large clinical trials that evaluated antiplatelet and anticoagulant therapies, as discussed below. Despite these recent data, a number of questions remain about the use of antiplatelet and anticoagulant agents, including the optimal dosing of certain agents and the timing of their use, and whether certain agents might be preferred for specific subgroups of patients. There are a number of challenges in determining optimal medical management in patients with UA/NSTEMI.
ISBN: 1494489325
ISBN13: 9781494489328
Author: U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality
Publisher: CreateSpace Independent Publishing Platform
Format: Paperback
PublicationDate: 2013-12
Language: English
PageCount: 818
Dimensions: 7.5 x 1.85 x 9.25 inches
Weight: 48.64 ounces
Acute coronary syndrome (ACS) encompasses three similar yet distinct disorders: (1) ST–elevation myocardial infarction (STEMI), (2) non–ST elevation myocardial infarction (NSTEMI), and (3) unstable angina (UA). These disorders are often collapsed into just two categories—STEMI and UA/NSTEMI—because UA and NSTEMI have a similar pathophysiology, mortality rate, and management strategy when compared with STEMI. In the United States, approximately 1.4 million people are diagnosed with ACS each year, and 70 percent of them have UA/NSTEMI. UA/NSTEMI is defined by the presence of ischemic chest pain (or an equivalent), the notable absence of ST segment elevation on electrocardiography, and the presence of either ST segment depression or T-wave inversion on electrocardiography and/or abnormal cardiac biomarkers. The pathophysiology of UA/NSTEMI involves six possible etiologies: (1) thrombus arising from a disrupted or eroded plaque, (2) thromboembolism from an erosive plaque, (3) dynamic obstruction (such as coronary spasm), (4) progressive mechanical obstruction, (5) inflammation, or (6) coronary artery dissection. Most patients with UA/NSTEMI have thrombus formation or progressive arterial narrowing that leads to subtotal occlusion of an epicardial coronary artery. The difference between UA and NSTEMI is based on the presence of myocardial necrosis or infarction as suggested by serum tests such as creatine kinase-myocardial band, troponin I, or troponin T in NSTEMI. The standard treatment goals for patients with UA/NSTEMI involve the elimination of ischemic pain and the prevention of adverse events—death, recurrent ischemia, or myocardial infarction (MI). The cornerstone of short- and long-term treatment in all cases is medical therapy with antiplatelet and anticoagulant medications. Antiplatelet medications work by decreasing platelet aggregation and inhibiting thrombus formation. The timing of initiation of antiplatelet therapy in patients presenting with UA/NSTEMI is broadly classified as upstream if the therapy is initiated after admission but prior to cardiac catheterization or periprocedural if the agent is initiated at the time of or during the procedure. Antiplatelet therapy initiated during a hospitalization for UA/NSTEMI and continued for long-term management has been shown to reduce future cardiovascular events. Anticoagulant medications work by inhibiting blood clotting, either by antagonizing the effects of vitamin K or by blocking/inhibiting thrombin. The use of a parenteral anticoagulant, traditionally heparin, is standard treatment for patients hospitalized with ACS, and newer anticoagulants have been developed that improve outcomes, with similar or reduced bleeding risk compared with heparin. By virtue of its ability to inhibit factors associated with thrombosis and to reduce ischemic outcomes, each antiplatelet or anticoagulant agent has the potential to increase the risk of bleeding. The tradeoff between reduced ischemic risk and increased bleeding risk has been highlighted in a number of recent large clinical trials that evaluated antiplatelet and anticoagulant therapies, as discussed below. Despite these recent data, a number of questions remain about the use of antiplatelet and anticoagulant agents, including the optimal dosing of certain agents and the timing of their use, and whether certain agents might be preferred for specific subgroups of patients. There are a number of challenges in determining optimal medical management in patients with UA/NSTEMI.

Books - New and Used

The following guidelines apply to books:

  • New: A brand-new copy with cover and original protective wrapping intact. Books with markings of any kind on the cover or pages, books marked as "Bargain" or "Remainder," or with any other labels attached, may not be listed as New condition.
  • Used - Good: All pages and cover are intact (including the dust cover, if applicable). Spine may show signs of wear. Pages may include limited notes and highlighting. May include "From the library of" labels. Shrink wrap, dust covers, or boxed set case may be missing. Item may be missing bundled media.
  • Used - Acceptable: All pages and the cover are intact, but shrink wrap, dust covers, or boxed set case may be missing. Pages may include limited notes, highlighting, or minor water damage but the text is readable. Item may but the dust cover may be missing. Pages may include limited notes and highlighting, but the text cannot be obscured or unreadable.

Note: Some electronic material access codes are valid only for one user. For this reason, used books, including books listed in the Used – Like New condition, may not come with functional electronic material access codes.

Shipping Fees

  • Stevens Books offers FREE SHIPPING everywhere in the United States for ALL non-book orders, and $3.99 for each book.
  • Packages are shipped from Monday to Friday.
  • No additional fees and charges.

Delivery Times

The usual time for processing an order is 24 hours (1 business day), but may vary depending on the availability of products ordered. This period excludes delivery times, which depend on your geographic location.

Estimated delivery times:

  • Standard Shipping: 5-8 business days
  • Expedited Shipping: 3-5 business days

Shipping method varies depending on what is being shipped.  

Tracking
All orders are shipped with a tracking number. Once your order has left our warehouse, a confirmation e-mail with a tracking number will be sent to you. You will be able to track your package at all times. 

Damaged Parcel
If your package has been delivered in a PO Box, please note that we are not responsible for any damage that may result (consequences of extreme temperatures, theft, etc.). 

If you have any questions regarding shipping or want to know about the status of an order, please contact us or email to support@stevensbooks.com.

You may return most items within 30 days of delivery for a full refund.

To be eligible for a return, your item must be unused and in the same condition that you received it. It must also be in the original packaging.

Several types of goods are exempt from being returned. Perishable goods such as food, flowers, newspapers or magazines cannot be returned. We also do not accept products that are intimate or sanitary goods, hazardous materials, or flammable liquids or gases.

Additional non-returnable items:

  • Gift cards
  • Downloadable software products
  • Some health and personal care items

To complete your return, we require a tracking number, which shows the items which you already returned to us.
There are certain situations where only partial refunds are granted (if applicable)

  • Book with obvious signs of use
  • CD, DVD, VHS tape, software, video game, cassette tape, or vinyl record that has been opened
  • Any item not in its original condition, is damaged or missing parts for reasons not due to our error
  • Any item that is returned more than 30 days after delivery

Items returned to us as a result of our error will receive a full refund,some returns may be subject to a restocking fee of 7% of the total item price, please contact a customer care team member to see if your return is subject. Returns that arrived on time and were as described are subject to a restocking fee.

Items returned to us that were not the result of our error, including items returned to us due to an invalid or incomplete address, will be refunded the original item price less our standard restocking fees.

If the item is returned to us for any of the following reasons, a 15% restocking fee will be applied to your refund total and you will be asked to pay for return shipping:

  • Item(s) no longer needed or wanted.
  • Item(s) returned to us due to an invalid or incomplete address.
  • Item(s) returned to us that were not a result of our error.

You should expect to receive your refund within four weeks of giving your package to the return shipper, however, in many cases you will receive a refund more quickly. This time period includes the transit time for us to receive your return from the shipper (5 to 10 business days), the time it takes us to process your return once we receive it (3 to 5 business days), and the time it takes your bank to process our refund request (5 to 10 business days).

If you need to return an item, please Contact Us with your order number and details about the product you would like to return. We will respond quickly with instructions for how to return items from your order.


Shipping Cost


We'll pay the return shipping costs if the return is a result of our error (you received an incorrect or defective item, etc.). In other cases, you will be responsible for paying for your own shipping costs for returning your item. Shipping costs are non-refundable. If you receive a refund, the cost of return shipping will be deducted from your refund.

Depending on where you live, the time it may take for your exchanged product to reach you, may vary.

If you are shipping an item over $75, you should consider using a trackable shipping service or purchasing shipping insurance. We don’t guarantee that we will receive your returned item.

$65.99

    Condition

Arrives: -
In Stock

Overview
Acute coronary syndrome (ACS) encompasses three similar yet distinct disorders: (1) ST–elevation myocardial infarction (STEMI), (2) non–ST elevation myocardial infarction (NSTEMI), and (3) unstable angina (UA). These disorders are often collapsed into just two categories—STEMI and UA/NSTEMI—because UA and NSTEMI have a similar pathophysiology, mortality rate, and management strategy when compared with STEMI. In the United States, approximately 1.4 million people are diagnosed with ACS each year, and 70 percent of them have UA/NSTEMI. UA/NSTEMI is defined by the presence of ischemic chest pain (or an equivalent), the notable absence of ST segment elevation on electrocardiography, and the presence of either ST segment depression or T-wave inversion on electrocardiography and/or abnormal cardiac biomarkers. The pathophysiology of UA/NSTEMI involves six possible etiologies: (1) thrombus arising from a disrupted or eroded plaque, (2) thromboembolism from an erosive plaque, (3) dynamic obstruction (such as coronary spasm), (4) progressive mechanical obstruction, (5) inflammation, or (6) coronary artery dissection. Most patients with UA/NSTEMI have thrombus formation or progressive arterial narrowing that leads to subtotal occlusion of an epicardial coronary artery. The difference between UA and NSTEMI is based on the presence of myocardial necrosis or infarction as suggested by serum tests such as creatine kinase-myocardial band, troponin I, or troponin T in NSTEMI. The standard treatment goals for patients with UA/NSTEMI involve the elimination of ischemic pain and the prevention of adverse events—death, recurrent ischemia, or myocardial infarction (MI). The cornerstone of short- and long-term treatment in all cases is medical therapy with antiplatelet and anticoagulant medications. Antiplatelet medications work by decreasing platelet aggregation and inhibiting thrombus formation. The timing of initiation of antiplatelet therapy in patients presenting with UA/NSTEMI is broadly classified as upstream if the therapy is initiated after admission but prior to cardiac catheterization or periprocedural if the agent is initiated at the time of or during the procedure. Antiplatelet therapy initiated during a hospitalization for UA/NSTEMI and continued for long-term management has been shown to reduce future cardiovascular events. Anticoagulant medications work by inhibiting blood clotting, either by antagonizing the effects of vitamin K or by blocking/inhibiting thrombin. The use of a parenteral anticoagulant, traditionally heparin, is standard treatment for patients hospitalized with ACS, and newer anticoagulants have been developed that improve outcomes, with similar or reduced bleeding risk compared with heparin. By virtue of its ability to inhibit factors associated with thrombosis and to reduce ischemic outcomes, each antiplatelet or anticoagulant agent has the potential to increase the risk of bleeding. The tradeoff between reduced ischemic risk and increased bleeding risk has been highlighted in a number of recent large clinical trials that evaluated antiplatelet and anticoagulant therapies, as discussed below. Despite these recent data, a number of questions remain about the use of antiplatelet and anticoagulant agents, including the optimal dosing of certain agents and the timing of their use, and whether certain agents might be preferred for specific subgroups of patients. There are a number of challenges in determining optimal medical management in patients with UA/NSTEMI.
ISBN: 1494489325
ISBN13: 9781494489328
Author: U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality
Publisher: CreateSpace Independent Publishing Platform
Format: Paperback
PublicationDate: 2013-12
Language: English
PageCount: 818
Dimensions: 7.5 x 1.85 x 9.25 inches
Weight: 48.64 ounces
Acute coronary syndrome (ACS) encompasses three similar yet distinct disorders: (1) ST–elevation myocardial infarction (STEMI), (2) non–ST elevation myocardial infarction (NSTEMI), and (3) unstable angina (UA). These disorders are often collapsed into just two categories—STEMI and UA/NSTEMI—because UA and NSTEMI have a similar pathophysiology, mortality rate, and management strategy when compared with STEMI. In the United States, approximately 1.4 million people are diagnosed with ACS each year, and 70 percent of them have UA/NSTEMI. UA/NSTEMI is defined by the presence of ischemic chest pain (or an equivalent), the notable absence of ST segment elevation on electrocardiography, and the presence of either ST segment depression or T-wave inversion on electrocardiography and/or abnormal cardiac biomarkers. The pathophysiology of UA/NSTEMI involves six possible etiologies: (1) thrombus arising from a disrupted or eroded plaque, (2) thromboembolism from an erosive plaque, (3) dynamic obstruction (such as coronary spasm), (4) progressive mechanical obstruction, (5) inflammation, or (6) coronary artery dissection. Most patients with UA/NSTEMI have thrombus formation or progressive arterial narrowing that leads to subtotal occlusion of an epicardial coronary artery. The difference between UA and NSTEMI is based on the presence of myocardial necrosis or infarction as suggested by serum tests such as creatine kinase-myocardial band, troponin I, or troponin T in NSTEMI. The standard treatment goals for patients with UA/NSTEMI involve the elimination of ischemic pain and the prevention of adverse events—death, recurrent ischemia, or myocardial infarction (MI). The cornerstone of short- and long-term treatment in all cases is medical therapy with antiplatelet and anticoagulant medications. Antiplatelet medications work by decreasing platelet aggregation and inhibiting thrombus formation. The timing of initiation of antiplatelet therapy in patients presenting with UA/NSTEMI is broadly classified as upstream if the therapy is initiated after admission but prior to cardiac catheterization or periprocedural if the agent is initiated at the time of or during the procedure. Antiplatelet therapy initiated during a hospitalization for UA/NSTEMI and continued for long-term management has been shown to reduce future cardiovascular events. Anticoagulant medications work by inhibiting blood clotting, either by antagonizing the effects of vitamin K or by blocking/inhibiting thrombin. The use of a parenteral anticoagulant, traditionally heparin, is standard treatment for patients hospitalized with ACS, and newer anticoagulants have been developed that improve outcomes, with similar or reduced bleeding risk compared with heparin. By virtue of its ability to inhibit factors associated with thrombosis and to reduce ischemic outcomes, each antiplatelet or anticoagulant agent has the potential to increase the risk of bleeding. The tradeoff between reduced ischemic risk and increased bleeding risk has been highlighted in a number of recent large clinical trials that evaluated antiplatelet and anticoagulant therapies, as discussed below. Despite these recent data, a number of questions remain about the use of antiplatelet and anticoagulant agents, including the optimal dosing of certain agents and the timing of their use, and whether certain agents might be preferred for specific subgroups of patients. There are a number of challenges in determining optimal medical management in patients with UA/NSTEMI.

Books - New and Used

The following guidelines apply to books:

  • New: A brand-new copy with cover and original protective wrapping intact. Books with markings of any kind on the cover or pages, books marked as "Bargain" or "Remainder," or with any other labels attached, may not be listed as New condition.
  • Used - Good: All pages and cover are intact (including the dust cover, if applicable). Spine may show signs of wear. Pages may include limited notes and highlighting. May include "From the library of" labels. Shrink wrap, dust covers, or boxed set case may be missing. Item may be missing bundled media.
  • Used - Acceptable: All pages and the cover are intact, but shrink wrap, dust covers, or boxed set case may be missing. Pages may include limited notes, highlighting, or minor water damage but the text is readable. Item may but the dust cover may be missing. Pages may include limited notes and highlighting, but the text cannot be obscured or unreadable.

Note: Some electronic material access codes are valid only for one user. For this reason, used books, including books listed in the Used – Like New condition, may not come with functional electronic material access codes.

Shipping Fees

  • Stevens Books offers FREE SHIPPING everywhere in the United States for ALL non-book orders, and $3.99 for each book.
  • Packages are shipped from Monday to Friday.
  • No additional fees and charges.

Delivery Times

The usual time for processing an order is 24 hours (1 business day), but may vary depending on the availability of products ordered. This period excludes delivery times, which depend on your geographic location.

Estimated delivery times:

  • Standard Shipping: 5-8 business days
  • Expedited Shipping: 3-5 business days

Shipping method varies depending on what is being shipped.  

Tracking
All orders are shipped with a tracking number. Once your order has left our warehouse, a confirmation e-mail with a tracking number will be sent to you. You will be able to track your package at all times. 

Damaged Parcel
If your package has been delivered in a PO Box, please note that we are not responsible for any damage that may result (consequences of extreme temperatures, theft, etc.). 

If you have any questions regarding shipping or want to know about the status of an order, please contact us or email to support@stevensbooks.com.

You may return most items within 30 days of delivery for a full refund.

To be eligible for a return, your item must be unused and in the same condition that you received it. It must also be in the original packaging.

Several types of goods are exempt from being returned. Perishable goods such as food, flowers, newspapers or magazines cannot be returned. We also do not accept products that are intimate or sanitary goods, hazardous materials, or flammable liquids or gases.

Additional non-returnable items:

  • Gift cards
  • Downloadable software products
  • Some health and personal care items

To complete your return, we require a tracking number, which shows the items which you already returned to us.
There are certain situations where only partial refunds are granted (if applicable)

  • Book with obvious signs of use
  • CD, DVD, VHS tape, software, video game, cassette tape, or vinyl record that has been opened
  • Any item not in its original condition, is damaged or missing parts for reasons not due to our error
  • Any item that is returned more than 30 days after delivery

Items returned to us as a result of our error will receive a full refund,some returns may be subject to a restocking fee of 7% of the total item price, please contact a customer care team member to see if your return is subject. Returns that arrived on time and were as described are subject to a restocking fee.

Items returned to us that were not the result of our error, including items returned to us due to an invalid or incomplete address, will be refunded the original item price less our standard restocking fees.

If the item is returned to us for any of the following reasons, a 15% restocking fee will be applied to your refund total and you will be asked to pay for return shipping:

  • Item(s) no longer needed or wanted.
  • Item(s) returned to us due to an invalid or incomplete address.
  • Item(s) returned to us that were not a result of our error.

You should expect to receive your refund within four weeks of giving your package to the return shipper, however, in many cases you will receive a refund more quickly. This time period includes the transit time for us to receive your return from the shipper (5 to 10 business days), the time it takes us to process your return once we receive it (3 to 5 business days), and the time it takes your bank to process our refund request (5 to 10 business days).

If you need to return an item, please Contact Us with your order number and details about the product you would like to return. We will respond quickly with instructions for how to return items from your order.


Shipping Cost


We'll pay the return shipping costs if the return is a result of our error (you received an incorrect or defective item, etc.). In other cases, you will be responsible for paying for your own shipping costs for returning your item. Shipping costs are non-refundable. If you receive a refund, the cost of return shipping will be deducted from your refund.

Depending on where you live, the time it may take for your exchanged product to reach you, may vary.

If you are shipping an item over $75, you should consider using a trackable shipping service or purchasing shipping insurance. We don’t guarantee that we will receive your returned item.

X

Oops!

Sorry, it looks like some products are not available in selected quantity.

OK

Sign up to the Stevens Books Newsletter

For the latest books, recommendations, author interviews and more

By signing up, I confirm that I'm over 16. To find out what personal data we collect and how we use it, please visit. our Privacy Policy.