3 Mar 2025 • The 2025 ACC/AHA/Multisociety Guideline for Acute Coronary Syndromes (ACS) introduces key updates to treatment protocols.

Key Takeaways:

• Dual antiplatelet therapy (DAPT) is recommended for at least 12 months in ACS patients not at high bleeding risk, with ticagrelor or prasugrel preferred over clopidogrel for PCI.
• High-intensity statins remain essential, with ezetimibe and evolocumab suggested for those not meeting LDL targets.
• For revascularization, PCI is recommended for both culprit and nonculprit lesions in STEMI, while personalized strategies are encouraged for NSTE-ACS.
• Radial artery access is preferred over femoral during PCI, with intracoronary imaging recommended for complex coronary lesions.
• In cardiogenic shock, revascularization of the culprit artery is critical, but routine PCI of noninfarct arteries isn’t recommended.
• The microaxial flow pump may reduce mortality in cardiogenic shock but carries risks like bleeding and renal failure.
• Red blood cell transfusions may be considered for ACS patients with anemia but no active bleeding.
• Monitoring lipid levels 4 to 8 weeks after starting lipid-lowering therapy is recommended, and cardiac rehabilitation, including home-based programs, is emphasized for patients unable to attend in person.

Source: AHA Journal | Read Full Story