Comments on the 2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

Abstract The Committee on the Clinical Application of Cardiac Biomarkers (C-CB) of the International Federation of Clinical Chemistry (IFCC) represents international groups from laboratory medicine, cardiology and emergency medicine involved in providing global educational guidance pertaining to the analytical and clinical applications of cardiac biomarkers. For that reason, most of the members are involved with national and international studies and trials pertaining to high sensitivity (hs) cardiac troponins I and T (cTnI and cTnT) (1-3). Although the recently published ‘2020 European Society of Cardiology (ESC) guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation’ present some topics very well, the current special report was developed to delineate our specific concerns regarding the ESB guidance for the use of hs-cardiac troponin (hs-cTn) (4).

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Questions and answers on antithrombotic therapy: a companion document of the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

European Heart Journal ◽

10.1093/eurheartj/ehv407 ◽

2015 ◽

Vol 37 (3) ◽

pp. e1-e7 ◽

Cited By ~ 1

Keyword(s):

Antithrombotic Therapy ◽

Acute Coronary Syndromes ◽

St Segment Elevation ◽

St Segment ◽

Questions And Answers ◽

Coronary Syndromes ◽

Esc Guidelines

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ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC)

European Heart Journal ◽

10.1093/eurheartj/ehr236 ◽

2011 ◽

Vol 32 (23) ◽

pp. 2999-3054 ◽

Cited By ~ 2270

Author(s):

◽

C. W. Hamm ◽

J.-P. Bassand ◽

S. Agewall ◽

J. Bax ◽

...

Keyword(s):

European Society ◽

Acute Coronary Syndromes ◽

Task Force ◽

St Segment Elevation ◽

St Segment ◽

Coronary Syndromes ◽

Esc Guidelines ◽

European Society Of Cardiology

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Critical appraisal of the 2020 ESC guideline recommendations on diagnosis and risk assessment in patients with suspected non-ST-segment elevation acute coronary syndrome

Clinical Research in Cardiology ◽

10.1007/s00392-021-01821-2 ◽

2021 ◽

Author(s):

Evangelos Giannitsis ◽

Stefan Blankenberg ◽

Robert H. Christenson ◽

Norbert Frey ◽

Stephan von Haehling ◽

...

Keyword(s):

Acute Coronary Syndromes ◽

Critical Appraisal ◽

Scientific Evidence ◽

St Segment Elevation ◽

Coronary Syndrome ◽

Scientific Support ◽

Prognostic Assessment ◽

St Segment ◽

Coronary Syndromes ◽

Esc Guidelines

AbstractMultiple new recommendations have been introduced in the 2020 ESC guidelines for the management of acute coronary syndromes with a focus on diagnosis, prognosis, and management of patients presenting without persistent ST-segment elevation. Most recommendations are supported by high-quality scientific evidence. The guidelines provide solutions to overcome obstacles presumed to complicate a convenient interpretation of troponin results such as age-, or sex-specific cutoffs, and to give practical advice to overcome delays of laboratory reporting. However, in some areas, scientific support is less well documented or even missing, and other areas are covered rather by expert opinion or subjective recommendations. We aim to provide a critical appraisal on several recommendations, mainly related to the diagnostic and prognostic assessment, highlighting the discrepancies between Guideline recommendations and the existing scientific evidence.

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