(HealthDay News) — New guidelines for management of patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) have been developed and published online September 23 in Circulation.

Ezra A. Amsterdam, MD, from the University of California Davis Medical Center, and colleagues conducted an extensive literature review to revise the 2007 clinical practice guidelines for management of patients with unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI). Patients with UA and NSTEMI are indistinguishable at presentation and are considered together in these guidelines.

The researchers note that to more accurately convey the physiological rationale of the initial approach to care, the term “ischemia-guided strategy” has replaced “initial conservative management.” Patients with suspected acute coronary syndromes should be risk stratified; those with high-risk features should be referred immediately to the emergency department, while those with less severe symptoms may be considered for referral to the emergency department, a chest pain unit, or a facility capable of performing adequate evaluation. Low-risk patients can also benefit from guideline-directed medical therapy. Clinical areas requiring further research include use of combined, potent antithrombotic and anticoagulant therapy in specific patient groups.

“There have been tremendous advances in the diagnosis and management of NSTE-ACS since the last guideline,” Amsterdam said in a statement. “We attempted to improve the utility of the guidelines with a focused method that eliminated repetition of ancillary information.”

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Several members of the writing and review committees disclosed financial ties to the pharmaceutical and medical device industries.

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