The year in cardiology: acute coronary syndromes. The year in cardiology 2019
█ Current opinion
Adrian P. Banning1*, Filippo Crea2, and Thomas F. Lüscher3
1Department of Cardiology, John Radcliffe Hospital and University of Oxford, Oxford, UK;
2Fondazione Policlinico Univeristario A. Gemelli, Universita` Cattolica del Sacro Cuore, Rome, Italy; and
3Royal Brompton & Harefield Hospital, Imperial College, London, UK
Received 25 October 2019; revised 25 November 2019; editorial decision 13 December 2019; accepted 18 December 2019
The management of acute coronary syndromes (ACS) has made enormous progress over the last five decades due to the introduction of defibrillation, beta blockers, thrombolytics, aspirin, primary percutaneous transluminal intervention (PCI), P2Y12 inhibitors, statins, radial access, and eventually PCSK9 inhibitors, among others (1). However, in spite of all these remedies, there is a remaining acute mortality risk, in particular, in those presenting in cardiogenic shock or after resuscitation and an accruing number of major cardiovascular events (MACE) over the following years (2). Thus, there is an unmet need in the management of ACS. In 2019, there were a number of important papers published in the European Heart Journal and other journals that deepened our knowledge about the spectrum of ACS and their management. Today patients presenting with acute chest pain and changes in the electrocardiogram (ECG) or biomarkers may have ST-segment elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) caused by atheroma, coronary dissection (3), takotsubo syndrome (4, 5), MINOCA (Myocardial infarction with Non-Obstructed Coronary Arteries) (6), or myocarditis (7).