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Interventional management of acute coronary syndromes: applying the lessons of ST-elevation services to non-ST-elevation myocardial infarction
  1. Mark A de Belder
  1. Correspondence to Dr Mark A de Belder, Cardiothoracic Division, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK; mark.debelder{at}


Many countries have embarked on national strategies to translate evidence from trials of reperfusion therapy for ST-elevation myocardial infarction (STEMI) into clinical practice. Primary angioplasty has become the dominant mode of reperfusion, but the best outcomes depend on appropriate service re-configurations to ensure rapid, effective and comprehensive treatment. Although there are many differences in the treatment of STEMI and non-STEMI acute coronary syndromes (ACS), there are many parallels. Many of the changes in the system of care for STEMI patients could now be applied to the non-STEMI ACS population, providing faster and more efficient care and promising to deliver better outcomes. This article highlights additional changes to healthcare services that should be considered.

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.