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Management of Acute Coronary Syndromes (ACS) in patients presenting without persistent ST-segment elevation
ESC Clinical Practice Guidelines
Topics:
Acute Coronary Syndromes (ACS)
Summary
Current versions available to download
Current translated versions available to download:
AuthorsJean-Pierre Bassand FESC, Christian W. Hamm FESC, Diego Ardissino FESC, Eric Boersma FESC, Andrzej Budaj FESC, Francisco Fernandez-Aviles FESC, Keith A.A. Fox FESC, David Hasdai,E. Magnus Ohman FESC, Lars Wallentin FESC, William Wijns FESC
Endorsed by:
French version:
Prise en charge des syndromes coronaires aigus chez les patients qui se présentent sans élévation persistante du segment ST
European Heart Journal 2002; 23 (23) :1-36 
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Table of contents: Full Text (ESC Clinical Practice Guidelines)
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Epidemiology and natural history
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Pathophysiology
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The vulnerable plaque, Coronary thrombosis, The vulnerable patient, Endothelial vasodilatory dysfunction, Accelerated atherosclerosis, Secondary mechanisms, Myocardial injury |
Diagnosis and risk assessment
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Clinical presentation and history
Diagnostic tools:
- Physical examination
- Electrocardiogram
- Biochemical markers
- Echocardiography and non-invasive myocardial imaging, Imaging of the coronary anatomy
Differential diagnoses
Risk scores |
Treatment
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Anti-ischaemic agents:
Beta-blockers, Nitrates, Calcium channel blockers, New drugs
Anticoagulants:
Unfractionated heparin, Low molecular weight heparin, Factor-Xa inhibitors, Direct thrombin inhibitors, Vitamin K antagonists, Anticoagulants during percutaneous coronary intervention procedures in non-STsegment elevation acute coronary syndromes
Antiplatelet agents:
Acetylsalicylic acid (aspirin), Thienopyridines, Glycoprotein IIb/IIIa receptor inhibitors, Resistance to antiplatelet agents/drug interactions, Withdrawal of antiplatelet agents
Coronary revascularization:
Coronary angiography, Invasive vs. conservative strategy, Percutaneous coronary intervention, Coronary artery bypass graft, Respective indications for percutaneous coronary intervention or coronary artery bypass graft
Long-term management:
Lifestyle, Weight reduction, Blood pressure control, Management of diabetes, Interventions on lipid profile, Antiplatelet agents and anticoagulants, Beta-blockers, Angiotensin-converting enzyme inhibitors, Angiotensin-2 receptor blockers, Aldosterone receptor antagonists
Rehabilitation and return to physical activity |
Complications and their management
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Bleeding complications:
Predictors of bleeding risk, Impact of bleeding on prognosis, Management of bleeding complications, Impact of blood transfusion
Thrombocytopenia:
Heparin-induced thrombocytopenia, Glycoprotein IIb/inhibitor-induced thrombocytopenia |
Special populations and conditions
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The elderly:
Early diagnostic evaluation in the elderly, Therapeutic considerations
Gender:
Glycoprotein IIb/IIIa inhibitors in women, Revascularization and early invasive strategy among women
Diabetes mellitus
Chronic kidney disease:
Chronic kidney disease as a marker of risk of coronary artery disease, Contrast-induced nephropathy, Management of chronic kidney disease in patients with coronary artery disease,
Biomarkers in chronic kidney disease
Anaemia
Normal coronary arteries |
Management strategies
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First step: initial evaluation
Second step: diagnosis validation and risk assessment, Diagnosis validation, Risk assessment
Third step: invasive strategy, Conservative strategy, Urgent invasive strategy, Early invasive strategy
Fourth step: revascularization modalities
Fifth step: discharge and post-discharge management
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Previous versions
A complete list of ESC Clinical Practice Guidelines (current and previous versions) endorsed by ESC National Society Members is available here
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