The American College of Cardiology Foundation/American Heart Association released a focused update last week to their guidelines on management of unstable angina and non-ST-segment-elevation myocardial infarction (NSTEMI). The guidelines were originally issued in 2007 and were last updated in March 2011. This update replaces the March 2011 update.
The guideline writing committee looked at research on the newly approved oral P2Y12 receptor inhibitor agentsprasugrel and ticagrelor, and offered guidance on how to incorporate them into clinical practice, as well as comparisons of the different agents in various settings. The focused update covers the following areas:
- antiplatelet/anticoagulant therapy in patients with likely or definite unstable angina/NSTEMI,
- timing of discontinuation of P2Y12 receptor inhibitor agents for surgical procedures,
- initial invasive versus initial conservative strategies,
- long-term medical therapy and secondary prevention,
- special considerations in diabetes and chronic kidney disease and
- quality of care and outcomes for unstable angina/NSTEMI.
The update will be published in the Aug. 14 Circulation. The full text is available online.