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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Clinical trial–derived risk model may not generalize to real-world patients with acute coronary syndrome
Andrew T. Yan,Philip Jong,Raymond T. Yan,Mary Tan,David Fitchett,Chi-Ming Chow,Matthew T. Roe,Karen S. Pieper,Anatoly Langer,Shaun G. Goodman +9 more
TL;DR: The findings underscore the potential importance of risk model validation in the general ACS population rather than a clinical trial population to establish its generalizability before integration into clinical practice.
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Benefit of Early Statin Therapy in Patients With Acute Myocardial Infarction Who Have Extremely Low Low-Density Lipoprotein Cholesterol
Ki Hong Lee,Myung Ho Jeong,Ha Mi Kim,Youngkeun Ahn,Jong Hyun Kim,Shung Chull Chae,Young Jo Kim,Seung Ho Hur,In Whan Seong,Taek Jong Hong,Donghoon Choi,Myeong Chan Cho,Chong Jin Kim,Ki Bae Seung,Wook Sung Chung,Yangsoo Jang,Seung-Woon Rha,Jang Ho Bae,Jeong Gwan Cho,Seung-Jung Park,Kamir Investigators +20 more
TL;DR: Statin therapy in patients with AMI with LDL-C levels below 70 mg/dl was associated with improved clinical outcome and there were no differences in the risk of the composite of all-cause death, recurrent MI, and repeated percutaneous coronary intervention rate.
Journal ArticleDOI
P2Y12 gene H2 haplotype is not associated with increased adenosine diphosphate-induced platelet aggregation after initiation of clopidogrel therapy with a high loading dose.
Nicolas von Beckerath,Olga von Beckerath,Werner Koch,Marianne Eichinger,Albert Schömig,Adnan Kastrati +5 more
TL;DR: Carriage of P2Y12 H2 haplotype does not seem to affect the platelet response to a 600 mg loading dose of clopidogrel in coronary artery disease patients prior to stenting.
Journal ArticleDOI
Self-Efficacy as a Marker of Cardiac Function and Predictor of Heart Failure Hospitalization and Mortality in Patients With Stable Coronary Heart Disease: Findings From the Heart and Soul Study
TL;DR: It is indicated that measuring cardiac self-efficacy provides a rapid and potentially useful assessment of cardiac function among outpatients with CHD and was a reasonable proxy for predicting HF hospitalizations.
Journal ArticleDOI
Safety of clopidogrel being continued until the time of coronary artery bypass grafting in patients with acute coronary syndrome: a meta-analysis of 34 studies
TL;DR: While results are awaited, it is suggested ACS patients requiring urgent CABG proceed with surgery without delay for a clopidogrel-free period and Multinational trials are required to fully determine the balance of ischaemia and bleeding.
References
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Journal ArticleDOI
Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)
Scott M. Grundy,David W. Bilheimer,Alan Chait,Luther T. Clark,Margo A. Denke,Richard J. Havel,William R. Hazzard,Stephen B. Hulley,Donald B. Hunninghake,Robert A. Kreisberg,Penny M. Kris-Etherton,James M. McKenney,Michael A. Newman,Ernst J. Schaefer,Burton E. Sobel,Carolyn Somelofski,Milton C. Weinstein,H. Bryan Brewer,James I. Cleeman,Karen A. Donato,Nancy D. Ernst,Jeffrey M. Hoeg,Basil M. Rifkind,Jacques E. Rossouw,Christopher T. Sempos,Joanne M. Gallivan,Maureen N. Harris,Laurie Quint-Adler +27 more
TL;DR: Dairy therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD, and the fundamental approach to treatment is comparable.
Journal ArticleDOI
Effects of an angiotensin-converting -enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients
TL;DR: Ramipril significantly reduces the rates of death, myocardial infarction, and stroke in a broad range of high-risk patients who are not known to have a low ejection fraction or heart failure.
Journal Article
Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34)
R C Turner,Rury R. Holman,Irene M Stratton,Carole A. Cull,David R Matthews,Susan E. Manley,V Frighi,D Wright,Andrew Neil,E M Kohner,H McElroy,C Fox,D R Hadden,Grp Ukpds. +13 more
TL;DR: Since intensive glucose control with metformin appears to decrease the risk of diabetes-related endpoints in overweight diabetic patients, and is associated with less weight gain and fewer hypoglycaemic attacks than are insulin and sulphonylureas, it may be the first-line pharmacological therapy of choice in these patients.
Journal ArticleDOI
The Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels
Frank M. Sacks,Marc A. Pfeffer,Lemuel A. Moyé,Jean L. Rouleau,John D. Rutherford,Thomas G. Cole,Lisa E. Brown,J. W. Warnica,J. M. O. Arnold,Chuan Chuan C Wun,Barry R. Davis,Eugene Braunwald +11 more
TL;DR: It is demonstrated that the benefit of cholesterol-lowering therapy extends to the majority of patients with coronary disease who have average cholesterol levels and was also greater in patients with higher pretreatment levels of LDL cholesterol.
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)
TL;DR: The effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
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