New guidelines for the management of non-ST segment elevation acute coronary syndromes (NSTE-ACS) were released by the European Society of Cardiology in June 2007 replacing previous guidelines of 2002.
The new guidelines include all recent changes in the management of this syndrome, highlighting especially novel drugs that have recently become available in this indication. All very recent information from the latest randomised trials has been evaluated and incorporated in the recommendations.
The guidelines were researched and written by the ESC Task Force on NSTE-ACS, and were co-chaired by Prof. Jean-Pierre Bassand, Past-President of the European Society of Cardiology, and Chief of the Cardiology Department in Besançon, France; and Prof. Christian Hamm, Medical Director of the Kerckhoff Heart Center in Bad Nauheim, Germany.
These guidelines propose a comprehensive, practical strategies for the management of NSTE-ACS, covering diagnostic procedures (especially use of biomarkers), the optimal pharmacological environment, with respect to all the new drugs available, and indications for invasive evaluation and revascularisation strategies.
The novelty of these new guidelines is that they cover some special conditions that have been underestimated or ignored in the past by previous guidelines, but which are the most common problems encountered in daily routine practice. In particular, specific sections are dedicated to special populations such as the elderly, women, chronic renal failure, diabetes, or anemia; and to the management of bleeding complications.
Succinct summaries of the main recommendations make these guidelines easy to read and suitable for daily routine. The optimal management strategy is summarized in a special chapter which allows to translate the recommendations into a concept for daily routine. New is the option to take high-risk patients in a critical condition immediately to invasive evaluation before biochemical tests are available. This brings the physician´s experience back into to the decision process.