Clinical Perspectives and Pearls from the 2015 ESC NSTE-ACS Guidelines

Curr Cardiol Rep. 2016 May;18(5):48. doi: 10.1007/s11886-016-0722-0.

Abstract

Four years after the latest edition, the 2015 non-ST-segment elevation acute coronary syndromes guidelines of the European Society of Cardiology have been published. Novel aspects include a new diagnostic algorithm for non-ST-segment elevation myocardial infarction using high-sensitivity cardiac troponins as well as guidance on cardiac rhythm monitoring duration. A large section is dedicated to antiplatelet therapy including initiation and duration of dual-antiplatelet therapy as well as the management of patients requiring, at the same time, long-term oral anticoagulation. New sections include the management of antiplatelet agent in patients requiring coronary artery bypass surgery and of acute bleeding events related to antiplatelet agents, vitamin K antagonist (VKA), and non-VKA oral anticoagulant drugs. Current evidence supports the radial access over the femoral one for coronary angiography and percutaneous revascularization.

Keywords: Antiplatelet agents; Guidelines; High-sensitivity cardiac troponins; Myocardial infarction; P2Y12 inhibitors; Radial approach.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / diagnosis*
  • Acute Coronary Syndrome / drug therapy*
  • Anticoagulants / therapeutic use
  • Cardiology / methods*
  • Cardiology / standards
  • Cardiovascular Agents / therapeutic use
  • Combined Modality Therapy
  • Coronary Angiography / trends
  • Electrocardiography / trends
  • Humans
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / drug therapy*
  • Practice Guidelines as Topic*
  • Predictive Value of Tests
  • Societies, Medical

Substances

  • Anticoagulants
  • Cardiovascular Agents