Acute coronary syndromes in adults

Quality statements

Statement 1 Adults with a suspected acute coronary syndrome are assessed for acute myocardial infarction using the criteria in the universal definition of myocardial infarction.

Statement 2 Adults with non-ST-segment-elevation myocardial infarction (NSTEMI) or unstable angina are assessed for their risk of future adverse cardiovascular events using an established risk scoring system that predicts 6-month mortality to guide clinical management.

Statement 3 Adults with NSTEMI or unstable angina who have an intermediate or higher risk of future adverse cardiovascular events who are having coronary angiography (with follow-on percutaneous coronary intervention [PCI] if indicated), have it within 72 hours of first admission to hospital.

Statement 4 Adults with NSTEMI or unstable angina who are clinically unstable have coronary angiography (with follow-on PCI if indicated) as soon as possible, but within 24 hours of becoming clinically unstable.

Statement 5 Adults who are unconscious after cardiac arrest caused by suspected acute ST‑segment‑elevation myocardial infarction (STEMI) are not excluded from having coronary angiography (with follow-on primary PCI if indicated).

Statement 6 Adults with acute STEMI who present within 12 hours of onset of symptoms have primary PCI, as the preferred coronary reperfusion strategy, as soon as possible but within 120 minutes of the time when fibrinolysis could have been given.