Which treatment should never be used for unstable angina or NSTEMI?

Thrombolytics, often referred to as clot busters, are treatments that are typically used to dissolve blood clots in conditions like ST-elevation myocardial infarction (STEMI). However, in the case of unstable angina or non-ST-elevation myocardial infarction (NSTEMI), the use of thrombolytics is contraindicated.

This is because thrombolytics can lead to significant complications in patients who do not have a fully occlusive clot, which is often the case in unstable angina or NSTEMI. These conditions may arise from a partial blockage of a coronary artery rather than a complete occlusion, and administering thrombolytics could increase the risk of bleeding without the benefit of reopening a blocked artery effectively.

In contrast, treatments such as aspirin, anticoagulants, and beta blockers play significant roles in the management of unstable angina and NSTEMI. Aspirin reduces platelet aggregation, anticoagulants help prevent further clot formation, and beta blockers reduce heart workload and ischemia. Hence, while these treatments are beneficial in the context of unstable angina and NSTEMI, thrombolytics are not appropriate and should never be used.