Acute coronary ischemic syndromes span the spectrum from unstable angina to myocardial infarction. Within this spectrum, current classifications distinguish ST-elevation myocardial infarction, which is treated using a reperfusion strategy, from non–ST-elevation myocardial infarction, which is treated medically. This distinction replaces the terms Q-wave myocardial infarction andnon–Q-wave myocardial infarction, respectively, a classification used in many of the older trials referred to in our review article. Although we agree with Dr Phibbs that the term non–Q-wave myocardial infarction is outdated, there is no evidence that patients with non–ST-elevation myocardial infarction or non–Q-wave myocardial infarction benefit from reperfusion therapy. Therefore, regardless of the terminology, these patients are prime candidates for the new therapies outlined in our article.
Weitz JI, Bates SM. Dalteparin for Unstable Angina and Non–Q-Wave Myocardial Infarction—Reply. Arch Intern Med. 2000;160(20):3170. doi: