title: [ESC guidelines 2015. Non-ST-elevation acute coronary syndrome].
abstract: In August 2015 the European Society of Cardiology (ESC) published new guidelines for the management of acute coronary syndrome in patients presenting without persistent ST-segment elevation, which incorporate the scientific progress since 2011. The innovation with probably the most impact on the clinical practice is the introduction of 0 h/1 h protocols for exclusion or inclusion of myocardial infarction without ST-segment elevation. These 0 h/1 h protocols are equally recommended to the established 0 h/3 h protocol. For these protocols blood is drawn on admission and 1 h later and the troponin level is analyzed by means of highly sensitive troponin assays. Troponin cut-off values were validated in several large studies, therefore, now facilitating a faster exclusion of myocardial infarction with an equal negative predictive value to 3 h protocols. Additionally, access via the radial artery is recommended over a femoral artery access for coronary angiography and when necessary the subsequent coronary intervention. Other novel aspects apply to the anti-ischemic and anti-thrombotic medication.
authors.affiliation: Medizinische Klinik II (Kardiologie/Angiologie/Intensivmedizin), Universitäres Herzzentrum Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Jobs
authors.affiliation: Medizinische Klinik II (Kardiologie/Angiologie/Intensivmedizin), Universitäres Herzzentrum Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. holger.thiele@uksh.de.
authors.forename: H
authors.initials: H
authors.lastname: Thiele
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D002309:Cardiology / Q000592:standards*; D017023:Coronary Angiography / Q000592:standards; D005060:Europe; D006801:Humans; D015912:Thrombolytic Therapy / Q000592:standards*; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I
keywords: Guidelines; Myocardial infarction; NSTE-ACS; NSTEMI; Unstable Angina pectoris