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
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The present guidelines supersede the 1994 guidelines and summarize both the evidence and expert opinion and provide final recommendations for both patient evaluation and therapy.Abstract:
The American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines was formed to make recommendations regarding the diagnosis and treatment of patients with known or suspected cardiovascular disease. Coronary artery disease (CAD) is the leading cause of death in the United States. Unstable angina (UA) and the closely related condition non–ST-segment elevation myocardial infarction (NSTEMI) are very common manifestations of this disease. These life-threatening disorders are a major cause of emergency medical care and hospitalizations in the United States. In 1996, the National Center for Health Statistics reported 1 433 000 hospitalizations for UA or NSTEMI. In recognition of the importance of the management of this common entity and of the rapid advances in the management of this condition, the need to revise guidelines published by the Agency for Health Care Policy and Research (AHCPR) and the National Heart, Lung and Blood Institute in 1994 was evident. This Task Force therefore formed the current committee to develop guidelines for the management of UA and NSTEMI. The present guidelines supersede the 1994 guidelines.
The customary ACC/AHA classifications I, II, and III summarize both the evidence and expert opinion and provide final recommendations for both patient evaluation and therapy:
Class I: Conditions for which there is evidence and/or general agreement that a given procedure or treatment is useful and effective .
Class II: Conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of a procedure or treatment.
Class IIa: Weight of evidence/opinion is in favor of usefulness/efficacy.
Class IIb: Usefulness/efficacy is less well established by evidence/opinion.
Class III: Conditions for which there is evidence and/or general agreement that the procedure/treatment is not useful/effective and in some cases may be harmful.
The weight of the evidence was ranked highest (A) if the data …read more
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Rimonabant: a cannabinoid receptor type 1 blocker for management of multiple cardiometabolic risk factors.
TL;DR: As an agent with a novel mechanism of action, rimonabant has a potential to be a useful adjunct to lifestyle and behavior modification in treatment of multiple cardiometabolic risk factors, including abdominal obesity and smoking.
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Reduction in Heart Rate Variability with Traffic and Air Pollution in Patients with Coronary Artery Disease
Antonella Zanobetti,Diane R. Gold,Peter Stone,Helen Suh,Joel Schwartz,Brent A. Coull,Frank E. Speizer +6 more
TL;DR: After hospitalization for coronary artery disease, both particulate pollution and being in traffic, a marker of stress and pollution, were associated with decreased HRV.
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Understanding physicians' risk stratification of acute coronary syndromes: insights from the Canadian ACS 2 Registry.
Andrew T. Yan,Raymond T. Yan,Thao Huynh,Amparo Casanova,F. Emilio Raimondo,David Fitchett,Anatoly Langer,Shaun G. Goodman +7 more
TL;DR: In this article, the authors examined patient risk assessment by physicians in relation to treatment and objective risk score evaluation and the underlying patient characteristics that physicians consider to indicate high risk and found that patients considered as high risk were more likely to receive aggressive medical therapies and to undergo coronary angiography and revascularization.
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Percutaneous coronary intervention versus coronary bypass graft surgery for diabetic patients with unstable angina and risk factors for adverse outcomes with bypass: outcome of diabetic patients in the AWESOME randomized trial and registry
Steven P. Sedlis,Douglass A. Morrison,Jeffrey D. Lorin,Rick A. Esposito,Gulshan K. Sethi,Jerome Sacks,William G. Henderson,Frederick L. Grover,Kodangudi Ramanathan,Darryl Weiman,Jorge Saucedo,Tamim Antakli,Venki Paramesh,Stuart Pett,Sarah Vernon,Vladimir Birjiniuk,Frederick G.P. Welt,Mitchell W. Krucoff,Walter G. Wolfe,John C. Lucke,Sundeep Mediratta,David C. Booth,Edward Murphy,Herbert B. Ward,La Wayne Miller,Stefan Kiesz,Charles Barbiere,Daniel W. Lewis +27 more
TL;DR: It is concluded that PCI is a relatively safe alternative to CABG for diabetic patients with medically refractory unstable angina who are at high risk for CABGs.
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Invasive therapy along with glycoprotein IIb/IIIa inhibitors and intracoronary stents improves survival in non–ST-segment elevation acute coronary syndromes: a meta-analysis and review of the literature
Anthony A Bavry,Anthony A Bavry,Dharam J. Kumbhani,Rene Quiroz,Suneil R Ramchandani,Satish Kenchaiah,Satish Kenchaiah,Satish Kenchaiah,Elliott M. Antman +8 more
TL;DR: Routine invasive therapy in UA/NSTEMI patients along with adjunctive use of glycoprotein IIb/IIIa inhibitors and intracoronary stents improves survival.
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