Antiplatelet Therapy in Acute Coronary Syndromes

Abstract

The care of cardiovascular patients experiencing a myocardial infarction (MI) has evolved from simple bed rest and relief of pain to complex interventions and multiple medications that target both the short- and long-term risks associated with atherosclerosis and ischemia. Even the terminology has changed, from MI to acute coronary syndromes (ACSs). The term, acute coronary syndrome, refers to the clinical symptoms resulting from acute myocardial ischemia; it encompasses unstable angina, non-ST-elevation MI, and ST-elevation MI. Antiplatelet therapies are critically important in the management of patients with ACS. Antiplatelet therapies interfere with platelet aggregation and platelet activation both acutely and chronically and thus impact the development of acute MI. Thus, they are prescribed for millions of patients with ACS. As a result of this progress in treatment, nursing management of persons with ACS has also evolved. This article reviews the pathophysiology of ACS, the role of antiplatelet therapies, their effects on platelet adhesion, and the role of the nurse in caring for patients with ACS who are prescribed these important therapies.

Investigating the Relevance of Nursing Caring Interventions Delivered to Patients with Coronary Artery Disease at a Teaching Hospital in China: A Retrospective Study

“…Our findings are supported by the evidence whereby such interventions have been delivered because they are beneficial for cardiac stability and minimizing of frequent CAD attacks [24]. Education regarding lifestyle factors has been found as an essential part of the discharge process [12,27]. Several studies on cardiac rehabilitation for CAD patients suggested that, it is imperative that patients receive proper medical management of coronary risk factors and support for the adoption of a healthy lifestyle [28].…”

“…Among several efforts underway to search for innovative strategies to strengthen the workforce, the major responsibility falls on advanced practice nurses due to an increasing demand for better chronic disease management and improved health care efficiency for patients at a great extent [11]. The nurses' caring role as a counselor and educator during an acute CAD event has been found to be critical for helping patients understand complex therapies involved in treating ACS and developing a plan that fosters medication adherence so as to ensure safety and improved outcomes [12]. It was further added that nurse’s objectives for the discharge of CAD patients included preparation of a patient to return to usual activities.…”

Comparing the association of cardiovascular nursing care with blood pressure and length of stay of in-patients with coronary artery disease in Wuhan, China

“…This has been done through specialised clinics and programmes in primary care, worksites, and cardiac rehabilitation centres 16 , 17 . Provision of education on complex therapies in treating CAD, counselling on diet and lifestyle for risk factors modification and promotion on cardiac rehabilitation skills are among nursing roles delivered to patients with CAD 14 . A systematic review of randomised controlled trials revealed that nursing interventions (NI) for CAD patients have a beneficial impact on blood pressure (BP), lipids, physical activity, dietary intake, cigarette smoking, weight loss, healthcare utilisation, mortality, quality of life, and psychosocial outcomes.…”

“…The modern treatment of CAD depends on the nature of coronary artery blockage or damage. These include vascular interventions such as percutaneous intervention (PCIs) (coronary stents and balloon angioplasty), coronary artery bypass graft (CABG), and pharmacological therapy 13,14 . Patients have also benefited and improved their quality of life by attending cardiac rehabilitation programmes 15 .…”