ACS management

ACS supplement programme

In this learning programme, based on a BJC supplement ‘The post-acute coronary syndrome patient: optimising management’, we learn how to optimise management of the post-acute coronary syndrome (ACS) patient.

Two national audits, MINAP (Myocardial Ischaemia National Audit Project) and NACR (National Audit of Cardiac Rehabilitation) as well as registries such as GRACE (Global Registry of Acute Coronary Events) have provided a wealth of data. These together with numerous other data sources reveal a national picture of a major reduction in the incidence of myocardial infarction (MI). Furthermore whilst these events do still occur, these data indicate that we are increasingly successful in managing the acute event.

This success has lead to new considerations:
– The emerging concept of the very high risk patient: people with multiple events, cardiovascular disease in multiple sites and/or co-morbidities.
– The increasing numbers of survivors: success in managing cardiovascular disease is creating a new population of patients to care for.

The programme looks at the scope of the problem of ACS in the UK which still has 80,000 hospitalisations for MI every year, many of whom still present late due to a lack of insight into their situation. It discusses thrombus formation, dual antiplatelet therapy and the different agents, with consideration of the optimal duration of therapy. Finally, the complexities of discharge and aftercare are discussed, with reference to the primary care aspect.

Each module will have a series of multiple-choice questions. Its one a half hours of learning leads to one a half continuing professional development (CPD) credits.

The programme has been made available with an arms-length grant from AstraZeneca. It has been independently written by five highly-respected cardiology authors.


Professor Chris P Gale, Professor of Cardiovascular Medicine, University of Leeds; Honorary Consultant Cardiologist, York Teaching Hospital

Dr Wael Sumaya, BHF Clinical Research Training Fellow, University of Sheffield
Professor Robert F Storey, Professor of Cardiology, University of Sheffield; Academic Director, Sheffield Teaching Hospitals NHS Foundation Trust; Director, Cardiovascular Research Unit, Northern General Hospital, Sheffield

Dr Terry McCormack, Honorary Reader in Primary Care Medicine, Hull York Medical School; General Practitioner, Whitby
Dr Joe Mills, Consultant Interventional Cardiologist, Liverpool Heart and Chest Hospital; President, British Association for Cardiovascular Prevention and Rehabilitation

With thanks to Dr Kevin Cheng for assistance on the self-assessment aspect of the programme

ACS management module 1: scope of the problem in the UK

Released 19 September 2017   Programme: ACS management 0.5 CPD/CME credit, 0.5 hours

ACS management module 1: scope of the problem in the UK
  • the definition of acute coronary syndrome
  • the rates of myocardial infarction in the UK and the associated survival and re-infarction rates
  • interventional strategies for the management of acute coronary syndrome (ACS)
  • how to determine who is at very high risk of re-infarction
  • the policies for the prevention of ACS events and how to implement them

ACS management module 2: dual antiplatelet therapy

Released 19 September 2017   Programme: ACS management 0.5 CPD/CME credits

ACS management module 2: dual antiplatelet therapy
  • the mechanisms of thrombus formation in the coronary artery
  • use of dual antiplatelet therapy with clopidogrel, prasugrel and ticagrelor in post-acute coronary syndrome management
  • use of dual antiplatelet therapy beyond one year
  • use of shorter antiplatelet therapy (three to six months)
  • use of ticagrelor-based prolonged dual antiplatelet therapy in selected high risk in patients with myocardial infarction and other high-risk features

ACS management module 3: shared care to optimise outcome

Released 19 September 2017   Programme: ACS management 0.5 CPD/CME credits

ACS management module 3: shared care to optimise outcome
  • The effects of myocardial infarction of the overall health of patients
  • What should happen and what actually happens to post-ACS patients after hospital discharge
  • How to optimise (shared) care of the post-ACS patent
  • The role of cardiac rehabilitation programmes
  • How to reinforce preventative messages one-year after discharge