The ‘Ten Commandments’ for the 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
Jean‐Philippe Collet, Hölger Thiele
Abstract
The 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation (NSTE-ACS) were developed by the effort of the European Society of Cardiology (ESC). The guidelines are intended to support the clinical practice by pragmatic recommendations based on the body of evidence available until mid-2020 and on professional experience where evidence is currently not available. For this purpose, the ESC assembled a Task Force of interventional cardiologists, non-interventional cardiologists, cardiac surgeons, and nurses. The Task Force built on the 2015 version of the guidelines on NSTE-ACS and reviewed more recent high-quality data from clinical trials and meta-analyses. The new guidelines underwent extensive independent review organized by the ESC pointing out areas of uncertainty or controversies due to inconclusive evidence. In the review process, the Task Force carefully appraised this valuable input. Recommendations of previous guidelines remained unchanged unless the amendment was mandated by robust new evidence. To be able to present a document that covers all aspects of NSTE-ACS, overlap with other ESC Guidelines was also appreciated and recommendations were aligned wherever needed. Thus, previous recommendations were kept, unless new evidence necessitated a revision.