Medical management of acute coronary syndromes

Background: Recent updates to clinical guidelines and pharmacological indications have added to the complexity of acute coronary syndrome (ACS) management. Advanced practice nurses working with ACS patients need clear and up-to-date information to optimize patient care. Purpose: To provide a practical overview of the management of ACS from patient presentation through to long-term secondary prevention based on recent guidelines and randomized controlled trials, with particular emphasis on medical management. Methods: Systematically reviewed recent studies and guidelines published 2011-2015 using PubMed search terms including "ACS management," "ACS hospital care," and "ACS secondary prevention." Conclusions: The last decade has seen an increase in the number of antithrombotic (anticoagulant and antiplatelet) agents and an expansion of their licensed indications for treatment of ACS patients. Future trials will help identify which subgroups of patients will gain the greatest benefit from more intense antithrombotic therapy. Implications for practice: Management of ACS is dependent on individual patient characteristics and risk stratification. Greater choice among therapies available for acute and long-term management will help to achieve optimal, patient-tailored care.