The incidence of
ST-segment elevation myocardial infarction (
STEMI) has significantly decreased. Conversely, the rate of non-
STEMI (
NSTEMI) has increased. Patients with
NSTEMI have lower short-term mortality compared to patients with
STEMI, whereas at long-term follow-up, the mortality becomes comparable. This might be due to the differences in baseline characteristics, including older age and a greater prevalence of comorbidities in the
NSTEMI population. Although antithrombotic strategies used in patients with
NSTEMI have been well studied in clinical trials and updated guidelines are available, patterns of use and outcomes in clinical practice are less well described. Thus, a panel of Italian cardiology experts assembled under the auspices of the "Campania
NSTEMI Study Group" for comprehensive discussion and consensus development to provide practical recommendations, for both clinical and interventional cardiologists, regarding optimal management of antithrombotic
therapy in patients with
NSTEMI. This position article presents and discusses various clinical scenarios in patients with
NSTEMI or
unstable angina, including special subsets (eg, patients aged ≥85 years, patients with
chronic renal disease or previous cerebrovascular events, and patients requiring triple
therapy or long-term antithrombotic
therapy), with the panel recommendations being provided for each scenario.