Treatment strategies and outcomes in patients with non-ST-elevation acute coronary syndrome in the Netherlands

Acute coronary syndrome (ACS) is predominantly caused by acute luminal narrowing due to sudden thrombus formation or plaque haemorrhage imposed on an atherosclerotic plaque [1]. A luminal thrombus forms as a direct consequence of plaque rupture or erosion. The initial electrocardiogram can be used to differentiate ST-elevation myocardial infarction (STEMI) and non-ST-elevation acute coronary syndrome (NSTE-ACS). Patients with STEMI are characterised by a complete and persistent occlusion of a large epicardial coronary artery and are best managed with immediate revascularisation by primary percutaneous coronary intervention [2]. Primary percutaneous coronary intervention (PCI) for STEMI is associated with a reduction in mortality compared with other reperfusion strategies [3]