European Society of Cardiology
Welcome to the European Society of Cardiology
 
Skip navigation links
Home
About the ESC
Membership
Communities
Congresses
Education
Guidelines & Surveys
Journals
Initiatives
Our mission: to reduce the burden of cardiovascular disease in Europe
 
Guidelines ACS icon

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

Publication dateVersionsReferencesSize
2007Full TextEHJ 2007;28:1598-16601 MB
 Pocket guidelines
 PdaDownload the PDA Version
 Slideset701 KB
 CME Questions2 hours of External CME credits

Current translated versions available to download:

Authors

Jean-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

Bookmark and Share

Table of contents: Full Text (ESC Clinical Practice Guidelines)

Epidemiology and natural history

Pathophysiology

 

The vulnerable plaque, Coronary thrombosis, The vulnerable patient, Endothelial vasodilatory dysfunction, Accelerated atherosclerosis, Secondary mechanisms, Myocardial injury

Diagnosis and risk assessment

 

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

 

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

 

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

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

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

Previous versions

 2003

Erratum
European Heart Journal 2003

Management of ACS in patients presenting without persistent ST-segment elevation 2003 

 2002 European Heart Journal 2002;23:1809–1840 Acute Coronary Syndromes in patients presenting without persistent ST-segment elevation (Management of)
 2000 European Heart Journal 2000 21, 1406-1432 Management of Acute Coronary Syndromes: ACS without persistent ST segment elevation 


A complete list of ESC Clinical Practice Guidelines (current and previous versions) endorsed by ESC National Society Members is available here