188 - The Clot Thickens: Key Updates from the 2025 Acute Coronary Syndromes Guidelines

In this episode, we review the new 2025 ACC/AHA Acute Coronary Syndrome (ACS) guidelines, with a particular focus on guideline recommendations for analgesics, P2Y12 inhibitors, parenteral anticoagulation, and lipid management. Key Concepts Nitrates and opioids are recommended for symptomatic relief of chest pain. Some patients may not be appropriate for nitrates (e.g. recent PDE-5 inhibitor use, hypotension, or right ventricular infarction). Opioids are used for nitrate-refractory angina but have a theoretical risk of delaying the effect of oral antiplatelet medications. Prasugrel and ticagrelor are preferred P2Y12 inhibitors over clopidogrel in most patients. Patient-specific factors, including the use of PCI, play a role in P2Y12 inhibitor selection. Anticoagulation with heparin is recommended in nearly all acute coronary syndrome (ACS) scenarios. Alternative anticoagulants may be used depending on whether PCI/CABG is planned and whether the anticoagulant is used prior to PCI/CABG ("upstream") or during the PCI procedure itself. LDL goals after ACS have changed again. All ACS patients should have an LDL goal References Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online February 27, 2025.

You can listen to 188 - The Clot Thickens: Key Updates from the 2025 Acute Coronary Syndromes Guidelines online on Radio and Podcast. Open the player on this page to stream the available audio.

188 - The Clot Thickens: Key Updates from the 2025 Acute Coronary Syndromes Guidelines is an episode from HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast by Sean P. Kane, PharmD, BCPS.

This episode is 36:27 long.

This episode was published on Mar 14, 2025.

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