2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
Summary
This multisociety guideline comprehensively updates ACS management, integrating evidence since prior STEMI/NSTE-ACS documents and replacing the 2016 DAPT duration update. It spans diagnostics, revascularization strategies, and antithrombotic therapy with methodical evidence review.
Key Findings
- Comprehensive evidence review (July 2023–April 2024) integrating new ACS data.
- Retires and replaces prior DAPT duration update; aligns with 2021 revascularization guideline.
- Multiple recommendations updated; new recommendations added where data support.
Clinical Implications
Expect updated recommendations across antiplatelet/anticoagulant strategies (including DAPT duration), pathways for emergent PCI, risk stratification, and integration with revascularization guidelines, informing protocols and order sets.
Why It Matters
ACS guidelines shape global practice and quality metrics; this update will directly influence acute care pathways from prehospital triage to invasive management and secondary prevention.
Limitations
- Guideline synthesis depends on underlying study quality; abstract lacks granular recommendation details.
- English-language evidence focus may limit inclusion of non-English trials.
Future Directions
Implementation studies and registries to assess adherence and outcomes; clarification of areas with low certainty through targeted RCTs.
Study Information
- Study Type
- Systematic Review
- Research Domain
- Treatment/Diagnosis/Prevention
- Evidence Level
- I - Guideline based on comprehensive synthesis of high-level evidence
- Study Design
- OTHER