title: Clinical Perspectives and Pearls from the 2015 ESC NSTE-ACS Guidelines.
abstract: Four years after the latest edition, the 2015 non-ST-segment elevation acute coronary syndromes guidelines of the European Society of Cardiology have been published. Novel aspects include a new diagnostic algorithm for non-ST-segment elevation myocardial infarction using high-sensitivity cardiac troponins as well as guidance on cardiac rhythm monitoring duration. A large section is dedicated to antiplatelet therapy including initiation and duration of dual-antiplatelet therapy as well as the management of patients requiring, at the same time, long-term oral anticoagulation. New sections include the management of antiplatelet agent in patients requiring coronary artery bypass surgery and of acute bleeding events related to antiplatelet agents, vitamin K antagonist (VKA), and non-VKA oral anticoagulant drugs. Current evidence supports the radial access over the femoral one for coronary angiography and percutaneous revascularization.
authors.affiliation: Division of Cardiology, Interventional Cardiology Unit, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland. marco.roffi@hcuge.ch.
authors.forename: Marco
authors.initials: M
authors.lastname: Roffi
authors.affiliation: Division of Cardiology, Interventional Cardiology Unit, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland.
authors.forename: Baris
authors.initials: B
authors.lastname: Gencer
authors.affiliation: Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Storey
authors.affiliation: Institute of Cardiology, Catholic University School of Medicine, Rome, Italy.
authors.forename: Felicita
authors.initials: F
authors.lastname: Andreotti
authors.affiliation: Institute of Pharmacology, Catholic University School of Medicine, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Patrono
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D000925:Anticoagulants / Q000627:therapeutic use; D002309:Cardiology / Q000379:methods* / Q000592:standards; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017023:Coronary Angiography / Q000639:trends; D004562:Electrocardiography / Q000639:trends; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012955:Societies, Medical
chemical_list: D000925:Anticoagulants; D002317:Cardiovascular Agents
keywords: Antiplatelet agents; Guidelines; High-sensitivity cardiac troponins; Myocardial infarction; P2Y12 inhibitors; Radial approach