Kommentar zu den Leitlinien (2023) der ESC zum Akuten Koronarsyndrom (ACS)

The current 2023 European Society of Cardiology (ESC) guidelines on acute coronary syndromes (ACS) describe ACS as a disease spectrum and, therefore, for the first time combine the recommendations for the management of patients with ST-elevation myocardial infarction and non-ST-elevation ACS in one set of guidelines. The guidelines have evaluated new treatment concepts and extensive study data and provide, among others, recommendations for an individualized antithrombotic treatment, timing and completeness of myocardial revascularisation, the importance of intracoronary imaging and physiology, myocardial infarction with non-obstructive coronary arteries (MINOCA) as well as special clinical situations. Furthermore, they underline the importance of secondary prevention and the inclusion of patients in treatment decisions. Overall, these very comprehensive guidelines provide clear recommendations on the diagnostics, initial management, invasive and revascularisation strategies as well as on non-pharmacological and pharmacological treatment of patients with ACS in the acute phase, the period of the first 12 months after ACS and especially for long-term treatment.