❤️ Acute Coronary Syndrome: Reperfusion & Antithrombotics
This tool gives the reperfusion or intervention timing and the antiplatelet/anticoagulation strategy for acute coronary syndrome, separating STEMI from NSTE-ACS.
Acute Coronary Syndrome: Reperfusion & Antithrombotics
ACS type
Primary PCI feasible within 120 min (for STEMI)
Time from onset (for STEMI)
NSTE-ACS risk stratification
When to use
Use to choose reperfusion in STEMI (primary PCI vs thrombolysis by time and feasibility) and intervention timing in NSTE-ACS by risk, with the antithrombotic backbone.
How it works
STEMI: primary PCI if feasible ≤ 120 min, else thrombolysis within 12 h then transfer. NSTE-ACS: no thrombolysis, intervention by risk (very-high < 2 h, high < 24 h, intermediate < 72 h, low selective). DAPT (aspirin + ticagrelor) + parenteral anticoagulant ≥ 12 months.
Key points
- NSTE-ACS is never thrombolysed; the decision is intervention timing by risk, whereas STEMI hinges on the earliest reperfusion. (original synthesis · not guideline verbatim)
- Ticagrelor is the preferred P2Y12 agent; prasugrel is limited to known coronary anatomy planned for PCI.
- Add β-blocker, statin, and ACEi/ARB unless contraindicated, and assess bleeding risk (CRUSADE).
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.