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Improving outcomes in coronary artery disease

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Systems, procedures and policies are needed to further reduce the toll of cardiovascular disease

Although major advances have been made in many aspects of the treatment of heart disease, rates of mortality and morbidity from acute coronary syndromes (ACS) in Australia and New Zealand remain significant. The SNAPSHOT ACS study reported outcomes of patients presenting with ACS.1 The 18-month mortality for patients presenting with an ST-elevation myocardial infarction was 16.2%, 16.3% for those presenting with a non-ST-elevation myocardial infarction, and 6.8% for those with unstable angina. Although these outcomes are a substantial advance on historical data, there is still much room for improvement.2 It is therefore timely that the National Heart Foundation (NHF) and the Cardiac Society of Australia and New Zealand (CSANZ) have revised the Australian guidelines for the management of ACS (summarised in this issue of the MJA).3 The NHF, CSANZ and all involved should be congratulated on the development of these guidelines.

The revised ACS guidelines simplify the target time for myocardial reperfusion in patients presenting with an ST-elevation myocardial infarction. Primary…