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Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Acute coronary syndrome (ACS) remains one of the leading causes of cardiovascular morbidity and mortality. Recent advances in high-sensitivity cardiac troponin assays, multimodal imaging, and antithrombotic therapies have introduced more individualized risk assessment and management. This review highlights a precision-oriented diagnostic pathway, which integrates the 0\/1-hour algorithm with imaging modalities for the comprehensive evaluation of culprit and non-culprit lesions. Revascularization strategies are advancing, with imaging-guided percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), enabling more tailored approaches for complex diseases. Meanwhile, mechanical circulatory support offers potential benefits for cardiogenic shock; nevertheless, there are uncertainties regarding optimal timing and patient selection. Long-term antithrombotic therapy is becoming increasingly optimized. Recent strategies have focused on reducing the duration of dual antiplatelet therapy (DAPT) and exploring de-escalation approaches such as P2Y12 inhibitor monotherapy. Secondary prevention extends beyond lipid-lowering therapies and includes metabolic and anti-inflammatory interventions. Collectively, these advancements indicate a shift toward truly personalized care for ACS, aiming to improve outcomes by transitioning away from a one-size-fits-all approach.<\/jats:p>","DOI":"10.31083\/rcm39947","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:31:56Z","timestamp":1777458716000},"source":"Crossref","is-referenced-by-count":0,"title":["Advances in Diagnosis and Therapeutic Guidance for Acute Coronary Syndrome: A Narrative of A Precision Medicine Approach"],"prefix":"10.31083","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6360-3181","authenticated-orcid":true,"given":"Takuma","family":"Koike","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Nerima Hospital, 177-8521 Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9665-4102","authenticated-orcid":true,"given":"Tomiharu","family":"Niida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Nerima Hospital, 177-8521 Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7726-0802","authenticated-orcid":true,"given":"Seiji","family":"Koga","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Nerima Hospital, 177-8521 Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Yaginuma","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Nerima Hospital, 177-8521 Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kikuo","family":"Isoda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Nerima Hospital, 177-8521 Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-8421","authenticated-orcid":true,"given":"Kenji","family":"Inoue","sequence":"additional","affiliation":[{"name":"Tokyo Heart Rhythm Clinic Shinjuku, 151-0053 Tokyo, Japan"},{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Falk E, Nakano M, Bentzon JF, Finn AV, Virmani R. 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