Journal ArticleDOI
A Clinical Trial of a Chest-Pain Observation Unit for Patients with Unstable Angina
Michael E. Farkouh,Peter A. Smars,Guy S. Reeder,Alan R. Zinsmeister,Roger W. Evans,Thomas D. Meloy,Stephen L. Kopecky,Marvin R. Allen,Thomas G. Allison,Raymond J. Gibbons,Sherine E. Gabriel +10 more
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A CPU located in the emergency department can be a safe, effective, and cost-saving means of ensuring that patients with unstable angina who are considered to be at intermediate risk for cardiovascular events receive appropriate care.Abstract:
Background Nearly half of patients hospitalized with unstable angina eventually receive a non–cardiac-related diagnosis, yet 5 percent of patients with myocardial infarction are inappropriately discharged from the emergency department. We evaluated the safety, efficacy, and cost of admission to a chest-pain observation unit (CPU) located in the emergency department for such patients. Methods We performed a community-based, prospective, randomized trial of the safety, efficacy, and cost of admission to a CPU as compared with those of regular hospital admission for patients with unstable angina who were considered to be at intermediate risk for cardiovascular events in the short term. A total of 424 eligible patients were randomly assigned to routine hospital admission (a monitored bed under the care of the cardiology service) or admission to the CPU (where patients were cared for according to a strict protocol including aspirin, heparin, continuous ST-segment monitoring, determination of creatine kinase is...read more
Citations
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Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines)
Raymond J. Gibbons,Gary J. Balady,J. Timothy Bricker,Bernard R. Chaitman,Gerald F. Fletcher,Victor F. Froelicher,Daniel B. Mark,Ben D. McCallister,Aryan N. Mooss,William L. Winters,Elliott M. Antman,Joseph S. Alpert,David P. Faxon,Valentin Fuster,Gabriel Gregoratos,Loren F. Hiratzka,Alice K. Jacobs,Richard O. Russell,Sidney C. Smith +18 more
TL;DR: The 10 major areas of change reflected in the update are described in a format that can be read and understood as a stand-alone document and are referred to the full-length Internet version to completely understand the context of these changes.
Journal ArticleDOI
ACC/AHA 2002 Guideline Update for Exercise Testing: Summary Article
Raymond J. Gibbons,Gary J. Balady,J. Timothy Bricker,Bernard R. Chaitman,Gerald F. Fletcher,Victor F. Froelicher,Daniel B. Mark,Ben D. McCallister,Aryan N. Mooss,Michael G. O’Reilly,William L. Winters,Elliott M. Antman,Joseph S. Alpert,David P. Faxon,Valentin Fuster,Gabriel Gregoratos,Loren F. Hiratzka,Alice K. Jacobs,Richard O. Russell,Sidney C. Smith +19 more
TL;DR: The ACC/AHA guidelines for exercise testing that were published in 1997 have now been updated as mentioned in this paper and the full-text guidelines incorporating the updated material are available on the Internet (www.acc.org or www.americanheart.org).
Journal ArticleDOI
2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes: Executive Summary
Ezra A. Amsterdam,Nanette K. Wenger,Ralph G. Brindis,Donald E. Casey,Theodore G. Ganiats,David R. Holmes,Allan S. Jaffe,Hani Jneid,Rosemary F. Kelly,Michael C. Kontos,Glenn N. Levine,Philip R. Liebson,Debabrata Mukherjee,Eric D. Peterson,Marc S. Sabatine,Richard W. Smalling,Susan J. Zieman +16 more
TL;DR: In this paper, early hospital care, hospital discharge, and post-hospital discharge care are recommended for Acs, based on myocardial revascularization and initial evaluation and management.
Journal ArticleDOI
2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Jeffrey L. Anderson,Cynthia D. Adams,Elliott M. Antman,Charles R. Bridges,Robert M. Califf,Donald E. Casey,William E. Chavey,Francis M. Fesmire,Judith S. Hochman,Thomas N. Levin,A. Michael Lincoff,Eric D. Peterson,Pierre Theroux,Nanette K. Wenger,R. Scott Wright,Hani Jneid,Steven M. Ettinger,Theodore G. Ganiats,George J. Philippides,Alice K. Jacobs,Jonathan L. Halperin,Nancy M. Albert,Mark A. Creager,David L. DeMets,Robert A. Guyton,Frederick G. Kushner,E. Magnus Ohman,William G. Stevenson,Clyde W. Yancy +28 more
TL;DR: This poster presents a poster presented at the 2016 American Academy of Thoracic Surgeons conference on “Cardiovascular Angiography and Interventions: Foundations of Cardiovascular and Pulmonary Rehabilitation,” presented in Los Angeles, USA.
Journal ArticleDOI
ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina).
Eugene Braunwald,Elliott M. Antman,John W. Beasley,Robert M. Califf,Melvin D. Cheitlin,Judith S. Hochman,Robert H. Jones,Dean J. Kereiakes,Joel Kupersmith,Thomas N. Levin,Carl J. Pepine,John W. Schaeffer,Earl E. Smith,David E Steward,Pierre Theroux,Raymond J. Gibbons,Joseph S. Alpert,Kim A. Eagle,David P. Faxon,Valentin Fuster,Timothy J. Gardner,Gabriel Gregoratos,Richard O. Russell,Sidney C. Smith +23 more
TL;DR: The purpose of These Guidelines is to provide a framework for future research into the pathogenesis of UA/NSTEMI and to promote awareness of the need for informed consent for diagnosis and treatment of acute coronary syndrome.
References
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Journal ArticleDOI
Prognostic Value of a Treadmill Exercise Score in Outpatients with Suspected Coronary Artery Disease
Daniel B. Mark,Linda Shaw,Frank E. Harrell,Mark A. Hlatky,Kerry L. Lee,James R. Bengtson,Charles B. McCants,Robert M. Califf,David B. Pryor +8 more
TL;DR: The treadmill score is a useful and valid tool that can help clinicians determine prognosis and decide whether to refer outpatients with suspected coronary disease for cardiac catheterization, and was a better predictor of outcome than the clinical assessment.
Journal ArticleDOI
Missed diagnoses of acute myocardial infarction in the emergency department: Results from a multicenter study
Bruce D. McCarthy,Joni R. Beshansky,Joni R. Beshansky,Ralph B. D'Agostino,Ralph B. D'Agostino,Harry P. Selker,Harry P. Selker +6 more
TL;DR: The rate of missed acute myocardial infarction in the emergency department was only 1.9%, but death or potentially lethal complications occurred in 25% of missed AMI patients, and another 25% might have been prevented had patients who were recognized to have ischemic heart disease by the physician in the ED been admitted.
Journal ArticleDOI
A Rapid Diagnostic and Treatment Center for Patients With Chest Pain in the Emergency Department
Gibler Wb,John Paul Runyon,Levy Rc,Michael R. Sayre,Kacich R,Charles R. Hattemer,Hamilton C,Gerlach Jw,Walsh Ra +8 more
TL;DR: The Heart ER program provides an effective method for evaluating low- to moderate-risk patients with possible acute ischemic coronary syndrome in the ED setting.
Journal ArticleDOI
Comprehensive Strategy for the Evaluation and Triage of the Chest Pain Patient
James L. Tatum,Robert L. Jesse,Michael C. Kontos,Christopher S. Nicholson,Kristin L Schmidt,Charlotte S. Roberts,Joseph P. Ornato +6 more
TL;DR: Rapid perfusion imaging plays a key role in the risk stratification of low-risk patients, allowing discrimination of unsuspected high risk patients who require prompt admission and possible intervention from those who are truly at low risk.
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Clinical characteristics and natural history of patients with acute myocardial infarction sent home from the emergency room.
ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: Executive summary and recommendations: A report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee on the management of patients with unstable angina)
Eugene Braunwald,Elliott M. Antman,John W. Beasley,Robert M. Califf,Melvin D. Cheitlin,Judith S. Hochman,Robert H. Jones,Dean J. Kereiakes,Joel Kupersmith,Thomas N. Levin,Carl J. Pepine,John W. Schaeffer,Earl E. Smith,David E Steward,Pierre Theroux,Raymond J. Gibbons,Joseph S. Alpert,David P. Faxon,Valentin Fuster,Gabriel Gregoratos,Loren F. Hiratzka,Alice K. Jacobs,Sidney C. Smith +22 more