What is the recommended first-line treatment in acute coronary syndrome?

The recommended first-line treatment in acute coronary syndrome is antiplatelet therapy. This approach is critical because it helps to prevent the formation of additional blood clots that can worsen the condition or lead to a myocardial infarction (heart attack). When a patient presents with acute coronary syndrome, which includes unstable angina and non-ST elevation (NSTEMI) or ST elevation myocardial infarction (STEMI), the priority is to restore blood flow to the heart muscle and minimize ischemic damage.

Antiplatelet agents, such as aspirin and P2Y12 inhibitors (like clopidogrel), are essential in this treatment strategy. Aspirin inhibits the activation of platelets, which reduces the likelihood of clot formation at the site of a ruptured atherosclerotic plaque — a common trigger for acute coronary syndrome. This therapy is often started immediately upon diagnosis and is considered a cornerstone in the management of the condition.

In contrast, while surgery, beta-blockers, and ACE inhibitors have their roles in the management of cardiovascular diseases, they are not the primary intervention in the acute phase of coronary syndromes. Surgical options might be considered later for revascularization, beta-blockers are typically initiated after initial stabilization, and ACE inhibitors are usually introduced