The guidelines contain updated sections on definition, epidemiology, natural history and pathophysiology. The main focus is on diagnosis and risk stratification, treatment and management strategies. In addition, they discuss complications and their management and give advice on how to manage specific populations and conditions, such as the elderly, diabetics and patients with renal failure. They provide classes of recommendations and level of evidence for drug and invasive therapy. For the first time, the guidelines focus on both safety and efficacy and include bleeding risk in the recommendations.
Other highlights for the clinicians are:
• Troponins are the biomarker of choice and should be taken acutely in these patients. Results of the tests should be available within 60 minutes.
• The GRACE risk score is the preferred algorithm for risk assessment.
• In high risk patients, coronary angiography should be performed within 72 hours.
• Suggestions for diagnostic strategies in different risk classes of patients.
These guidelines deserve attention and recognition, and should improve the quality of management in patients with non ST-elevation ACS.