The first Guideline Spotlight issue of JACC, published online June 2, focuses on the recent 2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes (ACS), providing expert commentary and global perspectives on topics ranging from optimizing implementation to navigating gaps within evidence.

"With this issue, we introduce a new editorial approach at JACC: the Guideline Spotlight Issue. This format is designed to give major cardiovascular Clinical Practice Guidelines the attention they deserve," said JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC, in an editorial. "Guidelines should not mark the end of a process, but the beginning of a broader public conversation. They deserve to be read, debated, taught, and – when appropriate – applied. They also offer a unique opportunity to spotlight the gaps in our knowledge and the urgent need for new research."

Highlights from the issue include a "holistic view" of ACS from Elliott M. Antman, MD, and Eugene Braunwald, MD, MACC, as well as closer looks at the guideline from the perspective of treating and managing ACS in Latin America, Asia, Europe and "Down Under," respectively. Thought leaders like Sanjay Kaul, MBBS; Paul M. Ridker, MD, MPH, FACC; Roxana Mehran, MD, FACC; Behnood Bikdeli, MD, FACC, and others also dive deeper into various aspects of ACS management in separate pieces looking at the use of colchicine, ticagrelor monotherapy, dual antiplatelet therapy and more.

Shared decision-making is also an important topic and addressed in a perspective piece by Carolyn S.P. Lam, MD, and Erica Sarah Spatz, MD, FACC, while Sunil V. Rao, MD, FACC, offers a personal perspective on the guideline. Additionally, ACC Past President Cathleen Biga, MSN, MACC, and other ACC and MedAxiom leaders share how the ACC, through MedAxiom, Member Sections and its NCDR registries and ACC Accreditation Services, is helping clinicians tangibly implement clinical guidance at the point of care.

"By fostering collaboration between clinical and nonclinical expertise, accelerating the dissemination of best practices, and leveraging data-driven insights, the ACC is not only shaping the present but also securing a future where clinicians, hospitals, health systems, and others can work together as a team to consistently apply evidence-based practices for better patient outcomes," write Biga, et al.

Importantly, the focus issue also provides a forward-look at ACS, with Celina M. Yong, MD, FACC, and Robert M. Califf, MD, MACC, offering insights into the "Gaps Within Evidence Gaps" over the last quarter century and Valentin Fuster, MD, PhD, MACC, and Borja Ibanez, MD, PhD, questioning whether we are closer to the dream of a universal ACS guideline. "The new guideline represents not only a long-overdue update, but also a meaningful step toward global alignment in ACS care," write Fuster and Ibanez.

Access related clinician and patient resources in the ACS Guideline Hub.