2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for Acute Coronary Syndrome Management

📊 JAMA Clinical Guidelines Synopsis: The 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for management of patients with acute coronary syndrome (#ACS) recommends a loading dose of both aspirin and a P2Y12 inhibitor for all patients, followed by maintenance dual antiplatelet therapy for at least 1 year if the risk of bleeding is not high.

Ticagrelor or prasugrel are preferred over clopidogrel for patients with non–ST-elevation ACS, and high-intensity statins are advised to reduce major adverse cardiovascular events. For individuals requiring oral anticoagulation, discontinuation of aspirin after 1 to 4 weeks reduces bleeding risk.

The guideline also supports an invasive approach with intent for revascularization for intermediate- or high-risk patients, recommends radial over femoral access during coronary angiography, and advises complete revascularization in patients with ST-elevation myocardial infarction and multivessel disease.

https://ja.ma/4x1qogA