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September 13, 2016

Management of Non–ST-Elevation Myocardial InfarctionThe Bright Gleam of Progress, but Much Work Remains

Author Affiliations
  • 1TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA. 2016;316(10):1045-1047. doi:10.1001/jama.2016.11940

Cardiovascular disease remains the largest contributor to global mortality, accounting for nearly half of the 36 million annual deaths from noncommunicable diseases, making it a major priority for global health policy initiatives.1,2 In developed countries, mortality due to cardiovascular disease has declined approximately 50% to 80% during the late 20th and early 21st centuries.3 This success story is most certainly multifactorial. The last several decades have witnessed substantial advances in the understanding of the causative factors and pathophysiology underlying vascular disease, allowing for targeted approaches to risk factor reduction for primary prevention (eg, blood pressure and cholesterol control) as well as effective strategies for management of acute events and for secondary prevention of recurrent events. Incremental benefit was seen even during the last decade with the introduction of risk stratification tools to guide decisions regarding early invasive coronary strategies, more potent antiplatelet therapies, and improved drug-eluting stent technologies.46

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