The Insightful Corner Hub
Medical Intelligence · Est. 2012
Clinical pathway builder

Acute coronary syndrome — ED pathway

Version 3.2 · grounded in ESC 2024 + AHA/ACC 2025 + WHO PEN · adapted for Rwanda MoH district hospitals

Pathway canvas Trigger Action Decision Outcome
Suspected ACS12-lead ECG ≤10 minSTEMINSTEMI / UAPrimary PCI ≤90 minGRACE risk scoreEarly invasive ≤24h (high risk)
Evidence sources
  • ESC 2024 ACS GuidelineClass I
  • AHA/ACC 2025 NSTEMI Focused UpdateClass I
  • WHO PEN protocol 5 — Africa adaptationStrong
  • TIMI / GRACE 2.0 risk scoresValidated
Therapeutic comparison
AntiplateletNNT MACENNH bleed
Ticagrelor53143
Prasugrel47118
Clopidogrel92204
Patient-risk interpreter
GRACE 2.0 · 6-month mortality
12.4%
High risk · early invasive ≤24h recommended (Class I, ESC 2024)