The 2025 ACC/AHA Acute Coronary Syndrome guideline is the first major update since 2013, incorporating a decade of new evidence and clinical insights. The writing committee stayed on track and on time, reaching consensus on key recommendations, including checklist-based Class I and II interventions before discharge. They thoughtfully addressed legacy practices and controversial studies to ensure clarity and relevance. While some emerging data didn’t meet the threshold for formal inclusion, areas like discharge antiplatelet therapy, coronary imaging, and mechanical support devices were flagged as important for clinicians to monitor. The result is a practical, evidence-based tool to guide bedside decision-making.

In this interview, Drs. Roxana Mehran and Sunil V. Rao take listeners “Behind the 2025 Acute Coronary Syndrome Guidelines.”