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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The Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER)—Evaluating the impact of myocardial infarction on patient outcomes
John A. Spertus,Eric D. Peterson,John S. Rumsfeld,Philip G. Jones,Carole Decker,Harlan M. Krumholz +5 more
TL;DR: The PREMIER registry as discussed by the authors is a registry with detailed insights into patients' sociodemographic, clinical, and health status characteristics, as well as detailed monitoring of their inpatient and outpatient processes of care.
Journal ArticleDOI
Chest Pain Relief by Nitroglycerin Does Not Predict Active Coronary Artery Disease
Charles A. Henrikson,Eric E. Howell,David E. Bush,J. Shawn Miles,Glenn Meininger,Tracy Friedlander,Andrew C. Bushnell,Nisha Chandra-Strobos +7 more
TL;DR: This prospective study aimed to better assess the diagnostic and prognostic value of response to nitroglycerin as a predictor of an ischemic cause of chest pain in patients presenting with chest pain.
Journal ArticleDOI
Culprit-only or multivessel revascularization in patients with acute coronary syndromes: an American College of Cardiology National Cardiovascular Database Registry report
Sorin J. Brener,Sarah Milford-Beland,Matthew T. Roe,Deepak L. Bhatt,William S. Weintraub,Ralph G. Brindis +5 more
TL;DR: In patients with MV CAD, presenting with ACS and selected for PCI, performance of MV PCI appears to be associated with at least as successful an inhospital outcome as SV PCI.
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Ischemia Modified Albumin for the assessment of patients presenting to the emergency department with acute chest pain but normal or non-diagnostic 12-lead electrocardiograms and negative cardiac troponin T
Debashis Roy,Juan Quiles,Guillermo Aldama,Manas Sinha,Pablo Avanzas,Ramón Arroyo-Espliguero,David Gaze,Paul O. Collinson,Juan Carlos Kaski +8 more
TL;DR: IMA may be a useful biomarker for the identification of ACS in patients presenting with typical acute chest pain but normal or non-diagnostic ECGs.
Journal ArticleDOI
Cardiac Magnetic Resonance With Edema Imaging Identifies Myocardium at Risk and Predicts Worse Outcome in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome
Subha V. Raman,Orlando P. Simonetti,Marshall W. Winner,Jennifer A. Dickerson,Xin He,Ernest L. Mazzaferri,Giuseppe Ambrosio +6 more
TL;DR: In NSTE-ACS patients, rapid CMR identifies reversibly injured myocardium due to obstructive CAD and predicts worse outcomes.
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