Heart specialists have updated the guidelines for treating acute coronary syndrome (ACS).

The new guidelines simplify advice to doctors regarding the target time for myocardial reperfusion in patients presenting with an ST-elevation myocardial infarction.

Experts say that despite some big advances in the treatment of ACS, mortality and morbidity rates remain significant.

The new National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand guidelines provide advice on standardised assessment and management of suspected ACS regarding:

  • diagnosis and risk stratification of ACS
  • provision of acute reperfusion therapy and immediate post-fibrinolysis care for patients with ST-segment elevation myocardial infarction
  • risk stratification informing the use of routine versus selective invasive management for patients with non-ST-segment elevation ACS
  • administration of antithrombotic therapies in the acute setting and considerations affecting their long-term use
  • implementation of an individualised secondary prevention plan that includes both pharmacotherapies and cardiac rehabilitation

“This ensures that no matter where you live in Australia you are entitled to the same standard of care; health professionals have guidance on decision-making based on the urgency required and advice on co-ordinating where the patient is best served in the system,” says National Heart Foundation chief Professor Garry Jennings.

Associate Professor Andrew MacIsaac from St Vincent’s Hospital in Melbourne says it is important to improve public education regarding the symptoms of a heart attack, and to have pre-hospital electrocardiograms by ambulances to reduce treatment delays.

The guidelines have been published in the latest edition of the MJA.