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Contemporary themes in acute coronary syndrome management: from acute illness to secondary prevention

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Acute coronary syndrome (ACS; myocardial infarction and unstable angina) is the leading cause of mortality in Australia and accounts for more than 300 000 years of life lost due to premature death (aged < 65 years) annually. The cost of repeat ACS events in 2010 exceeded $8 billion.1 About half of the cardiovascular events in Australia occur in people who have had a prior hospital episode for coronary heart disease (CHD).2 Therefore, access to evidence-based and optimal ACS management in both the acute and long-term periods is of great importance.

In recent years, advances in monitoring, revascularisation and pharmacotherapy for acute illness have contributed to a reduction in mortality. However, a quarter of these survivors will be readmitted to hospital within a year of the index event, and a significant number of readmissions will result in death.3,4 Consequently, the demand for effective secondary prevention is intensifying, and ensuring access to structured management strategies that complement standard medical care is now a priority.