The recently released American College of Cardiology (ACC)/American Heart Association (AHA) 2014 Guideline for the Management of Patients with Non–ST-Elevation Acute Coronary Syndromes (NSTE-ACS) features a title change from the previous version as well as recognition of an alternate strategy for low-risk patients and the importance of ongoing postdischarge care.
Another update reflects evidence for the superior efficacy of newer antiplatelet agents. Ongoing P2Y12 inhibitor therapy is recommended for all NSTE-ACS patients irrespective of the initial treatment approach. But for the first time, said co-author Debabrata Mukherjee, MD, of Texas Tech University Health Sciences Center (El Paso, TX), in an email with TCTMD, the guidelines say choice of the more potent agent ticagrelor over clopidogrel is reasonable, as is use of prasugrel in stented patients who are not at high bleeding risk.
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