ACC CardiaCast Innovation in Action: What's New in ACS Care Delivery
10 snips
Nov 21, 2025 Dr. Sunil Rao, a leading interventional cardiologist at NYU Langone Health, and Dr. David Morrow, a critical care cardiology expert at Brigham and Women's Hospital, dive into the latest guidelines for acute coronary syndrome (ACS). They explore impactful changes in antiplatelet therapy and the importance of radial access in interventions. Emphasizing the need for training and addressing representation gaps in clinical trials, they also discuss leveraging AI and real-world evidence to enhance ACS care, ensuring it’s effective for all patient subgroups.
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Use Third-Generation P2Y12 Inhibitors
- Use third-generation P2Y12 inhibitors (ticagrelor or prasugrel) on top of aspirin for ACS when appropriate.
- Tailor choice and duration to bleeding risk and clinical pathway as outlined in the guideline figure.
Adopt Radial-First Access For PCI
- Prefer radial arterial access for ACS PCI whenever feasible to reduce complications and improve outcomes.
- Implement radial-first practice given class I recommendation carried into the ACS guideline.
Use Intracoronary Imaging-Guided PCI
- Use intracoronary imaging (IVUS or OCT) to guide PCI in ACS and complex disease whenever available.
- Invest in training and equipment because imaging-guided PCI now has a class I recommendation after randomized trials showing outcome benefit.