Non-ST-Segment Elevation Acute Coronary Syndrome

“The most important issue is not to miss the diagnosis of myocardial infarction. A high negative predictive value is of utmost importance.”

“The most important change in the guidelines compared with the 2015 [version] is the introduction with a strong class of recommendation of the 0 to 2-hour algorithm [for high-sensitivity cardiac troponin testing]. In terms of treatment, for revascularization, the categorization of the risk has been simplified into very high risk, high risk and low risk. The intermediate group has now become low risk because we have high-sensitivity cardiac troponin available. From the antithrombotic perspective, the two important changes are one on dual antithrombotic therapy following the in-hospital phase for patients with a requirement of oral anticoagulation undergoing PCI, and the class III indication for routine pretreatment with P2Y12 inhibitors.”

“In these guidelines, we have implemented the use of high-sensitivity troponins everywhere with the 0/1-hour algorithm. Equally important is a healthy lifestyle including smoking cessation, exercise, and a diet emphasising vegetables, fruits and whole grains while limiting saturated fat and alcohol.”