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Unstable angina occurs when a partially blocked coronary artery deprives the heart of blood and oxygen. The updated guidelines were issued jointly by the American Heart Association Task Force on Practice Guidelines and the American College of Cardiology Foundation.
"We have put it on equal footing with two other [blood-thinning] medications: clopidogrel (Plavix) and prasugrel (Effient)," lead author Dr. Hani Jneid, assistant professor of medicine and director of interventional cardiology research at Baylor College of Medicine in Houston, said in an American Heart Association news release.
The new guidelines state that Brilinta (ticagrelor), which was approved by the U.S. Food and Drug Administration in 2011, should also be considered to treat a type of heart attack known as non-ST segment elevation myocardial infarction, also known as NSTEMI.
"These conditions are very common and carry a high risk of death and recurrent heart attacks," said Jneid, who also is an interventional cardiologist at the Michael E. DeBakey VA Medical Center in Houston. "The [American Heart Association] and [American College of Cardiology Foundation] constantly update their guidelines so physicians can provide patients with the most appropriate, aggressive therapy with the goal of improving health and survival."
Although all patients with these conditions should still be given aspirin as soon as they are hospitalized, the updated guidelines outlined the following new recommendations:
- Brilinta or Plavix may be given to patients receiving medical therapy (e.g. aspirin) or having an artery-opening procedure. Patients unable to take aspirin may be given Effient for artery-opening procedures because research on this drug is focused on these patients.
- Patients undergoing invasive procedures should be given aspirin along with blood-thinning medication.
- Patients undergoing only treatment with medication should receive aspirin indefinitely and be given Brilinta or Plavix for at least 12 months.
The guidelines' authors added that doctors and hospitals should participate in a quality-of-care data registry to help track and measure outcomes, complications and adherence to evidence-based recommendations.
"While this focused update of the guidelines provides important guidance to clinicians, our recommendations are not substitutes for a physician's own clinical judgments and the tailoring of therapy based on individual variability and a patient's presentation and clinical diagnosis," Jneid said in the news release.
The new guidelines were published July 16 in Circulation: Journal of the American Heart Association and the Journal of the American College of Cardiology.
-- Mary Elizabeth Dallas
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