Experts from the European Society of Cardiology (ESC) have developed the first guidelines for acute coronary syndromes. Particular attention is paid to the importance of antiplatelet therapy, invasive evaluation and revascularization.
During the ESC 2023 annual meeting, European cardiologists presented an updated guideline on acute coronary syndrome. Document, published in the European Heart Journal covers all groups of clinical signs or symptoms, including unstable angina and all forms of myocardial infarction.
The authors emphasize that acute coronary syndrome (ACS) is a spectrum of conditions. The paper deals with unstable angina and all forms of acute myocardial infarction, with and without ST elevation.
Detailed recommendations for treatment are given, including anticoagulant and antiplatelet therapy. Most patients should undergo coronary angiography. In case of critical vessel stenosis, an emergency stent installation is performed in a specialized center. In the absence of such an opportunity, intravenous administration of a thrombolytic is recommended. Treatment options for incomplete coronary artery occlusion include elective stent placement, open chest bypass, or medical therapy alone.
Experts remind the critical importance of long-term treatment in order to prevent a recurrence. This approach consists in the use of antiplatelet agents and strict control of cholesterol levels. Patients are also shown a cardiorehabilitation program with lifestyle modification, including increased activity levels, a balanced diet, smoking cessation, and measures to eliminate psychosocial stress. Together, these approaches will help improve the quality of life of patients. Additional medical therapy is recommended to reduce the risk of developing heart failure.
A new section in the guidelines is devoted to the treatment of acute coronary syndrome in cancer patients. The authors noted that cancer increases the risk of ACS. In addition, these patients have an increased risk of bleeding. The document emphasizes the need to take this into account when making decisions about patient management. For patients with a predicted survival of at least six months, an invasive treatment strategy (coronary angiography with stent placement if necessary) is recommended. If you suspect the development of acute coronary syndrome against the background of anticancer therapy, a temporary cessation of this treatment is recommended.
2023-08-30 15:10:02
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