Advance PublicationCirculation JournalJCS STATEMENTdoi:10.1253/circj.CJ23-0096Executive Summary-Acute Coronary Syndrome in the Japan ResuscitationCouncil Guidelines for Resuscitation 2020-Migaku Kikuchi,MD,PhD;Yoshio Tahara,MD,PhD;Junichi Yamaguchi,MD,PhD;Takahiro Nakashima,MD,PhD;Osamu Nomura,MD,PhD;Akihito Tanaka,MD,PhD;Sunao Kojima,MD,PhD;Katsutaka Hashiba,MD;Naoki Nakayama,MD,PhD;Hiroyuki Hanada,MD,PhD;Toshiaki Mano,MD,PhD;Takeshi Yamamoto,MD,PhD;Kunihiro Matsuo,MD,PhD;Ichiro Takeuchi,MD,PhD;Tetsuya Matoba,MD,PhD;Hiroshi Nonogi,MD,PhD for the Japan Resuscitation Council (JRC)Acute Coronary Syndrome(ACS)Task Force and the Guideline Editorial Committeeon behalf of the Japanese Circulation Society (JCS)Emergency and Critical Care CommitteeTable of Contentsntroduction.................................................2ll.Prehospital Therapeutic InterventionsEvidence Evaluation Process.........2n ACS.4…71.Supplementary Oxygen in ACS.....7Abbreviati0 S…32.Prehospital Administration of Aspirin andSummary of Topics in the ACS Guidelines........3Nitroglycerin by Non-Physician HealthcareI.Diagnostic Interventions in STEMI..........................3Pr0 fessi0 S…71.12-Lead ECG in the Prehospital Setting......Ill.Triage Using Myocardial Biomarker,Cardiac Troponin (cTn),in the ED............................81.1.Prehospital 12-Lead ECG Acquisition With1.High-Sensitivity cTn to Rule-In and Rule-OutHospital Notification............4NSTEM81.2.Prehospital ECG Interpretation byIV.Decisions of Reperfusion Methods inN0n-Physicians.................…5STEMI.......1.3.Prehospital STEMI Activation of theV.ACS Algorithm 2020 for Initial EvaluationCatheterization Laboratory...6and Treatment..........................92.In Non-PCI-Capable Facilities.....6VI.Future Directions to 2025(Knowledge Gap)..102.1.DIDO Time in Non-PCI-Capable Facilities .....6References..........12Received February 19,2023;accepted February 19,2023;J-STAGE Advance Publication released online April 20,2023Department of Cardiovascular Medicine,Emergency and Critical Care Center,Dokkyo Medical University School of Medicine,Tochigi (M.K.);Department of Cardiovascular Medicine,National Cerebral and Cardiovascular Center,Osaka (Y.T.);Department of Cardiology,Tokyo Women's Medical University,Tokyo (J.Y.),Japan;Department of Emergency Medicine andMichigan Center for Integrative Research in Critical Care,University of Michigan,Ann Arbor,MI(T.N.),USA;Departmentof Emergency and Disaster Medicine,Hirosaki University,Aomori(O.N.,H.H.);Department of Cardiology,Nagoya UniversityGraduate School of Medicine,Nagoya(A.T.);Department of Intemal Medicine,Sakurajyuji Yatsushiro Rehabilitation HospitalYatsushiro (S.K.);Department of Cardiology,Saiseikai Yokohama-shi Nanbu Hospital,Yokohama (K.H.);Department ofCardiology,Kanagawa Cardiovascular and Respiratory Center,Yokohama (N.N.);Kansai Rosai Hospital CardiovascularCenter,Amagasaki (T.Mano);Division of Cardiovascular Intensive Care,Nippon Medical School Hospital,Tokyo (T.
