Give aspirin therapy promptly and continue in all patients with suspected ACS.
Proceed directly to coronary angiography in patients with STEMI who present to experienced centers or can be transferred to a referral center in order to perform a primary percutaneous intervention.
Administer a thrombolytic agent as an alternative to primary percutaneous interventions in suitable candidates with STEMI.
Give anticoagulant therapy with unfractionated heparin, low-molecular-weight heparin or bivalirudin, to moderate- and high-risk patients with ACS.
Administer clopidogrel or a newer P2Y12 receptor inhibitor in selected patients with ACS.
Consider administering glycoprotein IIb/IIIa antagonists in addition to aspirin and an anticoagulant in patients with high-risk NSTEMI, as adjunctive therapy in patients with STEMI undergoing primary percutaneous intervention, or as an alternative to P2Y12 receptor inhibitors.
Administer β-blockers early to patients with suspected ACS unless there are significant contraindications; give a nonselective β-blocker to patients with left ventricular dysfunction after an MI.
Administer nitroglycerin to with ACS with ongoing chest discomfort.
Administer an ACE inhibitor early in the course of ACS.
Prescribe high-potency HMG-CoA reductase inhibitors (statins) in patients with ACS and continue after hospitalization, with goal LDL<100 mg/dL.
Strongly advise all tobacco users who have had an acute coronary event to quit smoking.
Aim for glycemic control (glucose <180 mg/dL) in patients with diabetes.