Akutes Koronarsyndrom ohne ST-Hebungen: ESC-Richtlinien 2015

The 2015 ESC guidelines for the diagnosis and management of acute coronary syndrome in patients presenting without ST-segment elevation comprise seven important and clinically-relevant modifications pertaining to the following: (1) a more precise differentiation between acute myocardial infarction and unstable angina pectoris; (2) a simple triage-algorithm enabling us to rapidly “rule-out” or “rule-in” acute myocardial infarction using the high-sensitivity cardiac troponin T or I assay for detecting blood troponin on admission and 1 hour thereafter; (3) duration of cardiac rhythm monitoring; (4) platelet aggregation therapy including its begin and duration; (5) anticoagulation; (6) urgency and vascular approach for coronary angiography und potential coronary revascularization; (7) relevance of consequent and longlasting control of risk factors. As supplement to the 2015 ESC guidelines, for the first time, three additional documents with case-control studies have been elaborated, seeking to illustrate the concrete clinical impact of these new key recommendations based on short clinical case vignettes.