{"id":6946,"date":"2025-05-22T12:21:52","date_gmt":"2025-05-22T09:21:52","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=6946"},"modified":"2025-05-22T12:21:52","modified_gmt":"2025-05-22T09:21:52","slug":"practice-changing-updates-in-acs-management-acc-25-summary","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/practice-changing-updates-in-acs-management-acc-25-summary\/","title":{"rendered":"Practice-Changing Updates in ACS Management \u2013 ACC.25 Summary"},"content":{"rendered":"
Practice-Changing Updates in ACS Management \u2013 ACC.25 Summary<\/div>\n
<\/div>\n
Source: ACC.25 \u2013 Presented by Dr. Deepak Bhatt | April 2025<\/div>\n
1. No Need for Fasting Before Cardiac Cath:<\/span><\/div>\n
\u2022 Recent RCTs and meta-analysis show no increase in adverse events in non-fasting patients.<\/span><\/div>\n
\u2022 Fasting may reduce satisfaction and complicate diabetes management.<\/span><\/div>\n
\u2022 Especially in elective cases, fasting is unnecessary.<\/span><\/div>\n
2. Avoid unnecessary combination of antithrombotic agents.<\/span><\/div>\n
In patients with AF and stable CAD, the addition of aspirin to oral anticoagulation increases bleeding risk without providing additional ischemic protection, according to recent evidence.<\/div>\n
Despite these findings, dual therapy is still frequently prescribed in practice.<\/div>\n
Clinicians are encouraged to reassess the need for antiplatelet therapy in this population and align management with current guidelines that support anticoagulation monotherapy in stable casStudies such as ALT-DAPT and HOST-BR RCT suggest that shortening the duration of dual antiplatelet therapy (DAPT) to 1\u20133 months may be safe and effective in certain patients, particularly those at high risk of bleeding. Among these durations, 3 months appears to provide a good balance between reducing ischemic events and minimizing bleeding risk\u2014hence, it is considered the \u201csweet spot\u201d for many patients.<\/div>\n
4. Mixed Results in Mechanical Support Trials:<\/span><\/div>\n
\u2022 ECMO showed no survival benefit in a randomized trial.<\/span><\/div>\n
\u2022 Impella (DanGer Shock trial) showed possible mortality benefit but with more bleeding and vascular complications.<\/span><\/div>\n
5. Colchicine Shows No Benefit in ACS (CLEAR-SYNERGY Trial):<\/span><\/div>\n
\u2022 Despite lowering CRP, colchicine did not improve outcomes post-PCI.<\/span><\/div>\n
\u2022 Contradicts earlier smaller trials; not recommended in ACS.<\/span><\/div>\n
\u2022 Ongoing interest in IL-6 inhibition (ARTEMIS trial underway).<\/span><\/div>\n
6. SGLT2 Inhibitors in ACS:<\/span><\/div>\n
\u2022 DAPA-MI and EMPACT-MI: no MI reduction in ACS patients.<\/span><\/div>\n
\u2022 Sotagliflozin (SGLT1\/2) showed reduced MI and stroke in non-ACS populations.<\/span><\/div>\n
\u2022 Potential role in ACS, but further trials needed.<\/span><\/div>\n
7. Polypill Strategy Post-MI (SECURE Trial):<\/span><\/div>\n
\u2022 A cardiovascular polypill improves adherence and outcomes post-MI.<\/span><\/div>\n
\u2022 Emphasizes long-term management, lifestyle changes, and medication simplicity.<\/span><\/div>\n
\ud83d\udd17 ACC 2025 Clinical Trials to Watch with Deepak Bhatt, MD, MPH, MBA<\/div>\n","protected":false},"excerpt":{"rendered":"

Practice-Changing Updates in ACS Management \u2013 ACC.25 Summary Source: ACC.25 \u2013 Presented by Dr. Deepak Bhatt | April 2025 1. No Need for Fasting Before Cardiac Cath: \u2022 Recent RCTs and meta-analysis show no increase in adverse events in non-fasting patients. \u2022 Fasting may reduce satisfaction and complicate diabetes management. \u2022 Especially in elective cases, […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6946","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6946","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=6946"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6946\/revisions"}],"predecessor-version":[{"id":6947,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6946\/revisions\/6947"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=6946"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=6946"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=6946"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}