Precision Management of Acute Coronary Syndrome: "Time is Muscle"

freecme000
Published on Apr 6, 2025
in 2025 ACC/AHA/ACEP/SCAI guideline
2025.03.02
In addition to “open artery theory”, early revascularization for acute coronary syndrome (ACS) manifesting as STEMI and NSTEMI is another pivotal action fulfilling the “time is muscle” concept. In today’s special session focusing on 2025 ACC/AHA/ACEP/SCAI ACS guideline, we’ll detail into the timeline and actions in ACS management. Starting from prehospital activation of PPCI team, there will need emergency loading of dual antiplatelet aspirin/P2Y12 antagonist, beta-blocker and parenteral anticoagulant, emergency reperfusion for STEMI with or without multivessel coronary disease, emergency reperfusion for NSTEMI or NSTE-ACS with very high-, high-, intermediate- or low-risk clinical status, and early reperfusion in STE- or NSTE-ACS with cardiogenic shock, which indicating mechanical circulation support by Impella or VA-ECMO. The chain of survival in ACS is heavily dependent on “early artery open” and “save time for muscle recovery”.