Australian clinical guideline for diagnosing and managing acute coronary syndromes 2024

What’s new in this guideline?

Key changes in this guideline

• Introduction of consensus recommendations as a new category
• Dedicated practice points to meet the needs of women, older adults, First Nations peoples and people living in regional and remote areas
• Revised terminology and definitions of MI

Assessment and diagnosis

• Guidance on interpretation of electrocardiograms in people with suspected n or myocardial ischaemia (Section 2.2)
• Guidance on the use and interpretation of high-sensitivity cardiac troponin testing for more rapid detection of myocardial injury (Section 2.3)
• Introduction of high-sensitivity troponin-based clinical decision pathways to stratify risk in people with suspected ACS (Section 2.4)
• Recommendations to support management of people with suspected ACS presenting to primary care and regional and remote settings (Section 2.9)

Hospital care and reperfusion

• Updates on timing of reperfusion strategies in people with ST-segment elevation myocardial infarction (STEMI) (Section 3.1)
• Consideration of intravascular imaging to guide percutaneous coronary intervention in people with non-ST-segment elevation ACS (Section 3.3.4)
• Revised recommendations on the acute pharmacological management of ACS (Sections 3.4 and 3.5)
• Recommendations on haemodynamic support devices in people with ACS and cardiogenic shock (Section 3.6.2)
• Treatment considerations for people with ACS and multivessel disease without cardiogenic shock (Section 3.7) and SCAD (Section 3.9)

Recovery and secondary prevention

• New recommendations and practice points on person-centred, non-pharmacological secondary prevention care (Section 4.1)
• Vaccination recommendations for people with ACS (Section 4.2)
• Updates on duration of dual antiplatelet therapy and indications for long-term oral anticoagulation (Section 4.3.1)
• New recommendations on low-density lipoprotein cholesterol (LDL-C) treatment targets and post-ACS lipid-modifying therapy, including non-statin therapies (Section 4.3.2)
• Considerations for withholding beta blockers in select people with ACS with preserved left ventricular systolic function (Section 4.3.3)
• New recommendations on renin-angiotensin antagonist therapies (Section 4.3.4) and on initiating colchicine post-ACS (Section 4.3.5)