Acute coronary syndrome (PCI, CABG, secondary prevention)

Big picture

This topic is about what happens after ACS is recognized: how to reopen the artery, when to choose PCI or CABG, and how to prevent reinfarction.

Core exam logic:

ACS → ECG pathway → reperfusion/revascularization → antithrombotic therapy → secondary prevention

• STEMI: immediate reperfusion, preferably primary PCI.
• High-risk NSTEMI/unstable angina: early invasive angiography ± PCI/CABG.
• After survival: the patient remains high risk forever → intensive secondary prevention.

Modern ACS guidelines emphasize early invasive treatment for appropriate patients, dual antiplatelet therapy, high-intensity lipid lowering, cardiac rehabilitation, an