2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: comments from the Dutch ACS working group

P Damman, A W van 't Hof, J M Ten Berg, J W Jukema, Y Appelman, A H Liem, R J de Winter, P Damman, A W van 't Hof, J M Ten Berg, J W Jukema, Y Appelman, A H Liem, R J de Winter

Abstract

On behalf of the Dutch ACS working group, we discuss multiple recommendations which have been implemented in the 2015 ESC guidelines for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation.

Keywords: NSTE-ACS guidelines; NVVC ACS working group statement.

Conflict of interest statement

P. Damman, A.W. van ’t Hof, J.M. ten Berg, J.W. Jukema, Y. Appelman, A.H. Liem and R.J. de Winter declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
0 h/3 h rule-out algorithms using high-sensitivity cardiac troponin assays in patients presenting to the emergency department with suspected non-ST-elevation myocardial infarction (With permission of Oxford University Press (UK)© European Society of Cardiology, www.escardio.org)
Fig. 2
Fig. 2
0 h/1 h rule-in and rule-out algorithms using high-sensitivity cardiac troponin assays in patients presenting to the emergency department with suspected non-ST-elevation myocardial infarction (With permission of Oxford University Press (UK)© European Society of Cardiology, www.escardio.org)
Fig. 3
Fig. 3
Antithrombotic strategies in patients with non-ST-elevation acute coronary syndromes and non-valvular atrial fibrillation (With permission of Oxford University Press (UK)© European Society of Cardiology, www.escardio.org)
Fig. 4
Fig. 4
Selection of non-ST-elevation acute coronary syndrome treatment strategy and timing according to initial risk stratification (With permission of Oxford University Press (UK)© European Society of Cardiology, www.escardio.org)

References

    1. Roffi M, Patrono C, Collet JP, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC) Eur Heart J. 2016;37:267–315. doi: 10.1093/eurheartj/ehv320.
    1. Mueller C. Biomarkers and acute coronary syndromes: an update. Eur Heart J. 2014;35:552–556. doi: 10.1093/eurheartj/eht530.
    1. Hamm CW, Bassand JP, Agewall S, et al. ESC Committee for Practice Guidelines. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC) Eur Heart J. 2011;32:2999–3054. doi: 10.1093/eurheartj/ehr236.
    1. ACCOAST Investigators. Montalescot G, Bolognese L, Dudek D, et al. Pretreatment with prasugrel in non-ST-segment elevation acute coronary syndromes. N Engl J Med. 2013;369:999–1010. doi: 10.1056/NEJMoa1308075.
    1. Hansen ML, Sørensen R, Clausen MT, et al. Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation. Arch Intern Med. 2010;170:1433–1441. doi: 10.1001/archinternmed.2010.271.
    1. WOEST study investigators. Dewilde WJ, Oirbans T, Verheugt FW, et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013;381:1107–1115. doi: 10.1016/S0140-6736(12)62177-1.
    1. Katritsis DG, Siontis GC, Kastrati A, et al. Optimal timing of coronary angiography and potential intervention in non-ST-elevation acute coronary syndromes. Eur Heart J. 2011;32:32–40. doi: 10.1093/eurheartj/ehq276.
    1. Navarese EP, Gurbel PA, Andreotti F, et al. Optimal timing of coronary invasive strategy in non-ST-segment elevation acute coronary syndromes: a systematic review and meta-analysis. Ann Intern Med. 2013;158:261–270. doi: 10.7326/0003-4819-158-4-201302190-00006.
    1. TIMACS Investigators. Mehta SR, Granger CB, Boden WE, et al. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med. 2009;360:2165–2175. doi: 10.1056/NEJMoa0807986.
    1. Damman P, Hirsch A, Windhausen F, Tijssen JG, de Winter RJ, ICTUS Investigators 5-year clinical outcomes in the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) trial a randomized comparison of an early invasive versus selective invasive management in patients with non-ST-segment elevation acute coronary syndrome. J Am Coll Cardiol. 2010;55:858–864. doi: 10.1016/j.jacc.2009.11.026.

Source: PubMed

Подписаться