Patient characteristics, clinical presentation, comorbidities, co-medications and periprocedural aspects: determinants of treatment and rx duration.
6/ Treatment recommendations
NOVEL: Prasugrel, first choice over Tica/Clopi (ISAR-REACT 5).. controversial!
NOVEL: not recommended to administer pre-treatment in patients planned to early invasive strategy (lack of evidence from ACCOAST, ISAR-REACT5)
7/ Treatment combinations in patients with AF / duration of treatment:
- Bleeding risk determines, initially, the strategy.
- Ischemic risk may determine duration (particularly long term) of DAPT.
- DOAC+ p2Y12i combination of choice in AF
8/ Timing of invasive strategy
- Benefit of early invasive strategy correlates strongly with patient profile.
-- Very high risk: immediate PCI (<2h)
-- High risk: <24h
9/ New sections on SCAD related NSTEACS and MINOCA
- The importance of CMRi is highlighted in all patients with MINOCA
- Takotsubo is separated from MINOCA
10/ Periprocedural aspects of PCI in NSTEMI
- FFR may be used to assess non culprit lesiones
- IABP IIaC, in mechanical complications
- MCS in ACS + CS: IIbC