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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Optimizing P2Y12 Receptor Inhibition in Patients With Acute Coronary Syndrome on the Basis of Platelet Function Testing: Impact of Prasugrel and High-Dose Clopidogrel
Daniel Aradi,Adrienn Tornyos,Tünde Pintér,András Vorobcsuk,Attila Kónyi,József Faluközy,Gábor Veress,Balázs Magyari,Iván Horváth,András Komócsi +9 more
TL;DR: Switching patients with ACS who have HPR to treatment with prasugrel reduces thrombotic and bleeding events to a level similar to that of those without HPR; however, there is a higher risk of both thrombs and bleeding complications with high-dose clopidogrel.
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Simultaneous hybrid revascularization by carotid stenting and coronary artery bypass grafting: the SHARP study.
Francesco Versaci,Bernhard Reimers,Costantino Del Giudice,Joachim Schofer,Alessandro Giacomin,Salvatore Saccà,Roberto Gandini,Remo Albiero,Antonio Pellegrino,Fabio Bertoldo,Giovanni Simonetti,Luigi Chiariello +11 more
TL;DR: The findings indicate that in high-risk patients with coronary artery disease suitable for CABG and carotid artery disease, the hybrid revascularization by CAS immediately followed by CABGs is a promising and feasible therapeutic strategy.
Journal ArticleDOI
Long-Term Results After the Glycoprotein IIb/IIIa Inhibitor Abciximab in Unstable Angina One-Year Survival in the GUSTO IV-ACS (Global Use of Strategies To Open Occluded Coronary Arteries IV—Acute Coronary Syndrome) Trial
J.P. Ottervanger,Paul W. Armstrong,Elliott Barnathan,Eric Boersma,J.S. Cooper,Erik Magnus Ohman,Stefan James,Eric J. Topol,Lars Wallentin,Maarten L. Simoons +9 more
TL;DR: Compared with placebo, abciximab did not provide any survival benefit at 1 year in patients admitted with an acute coronary syndrome with ST depression and/or elevated troponin who were not scheduled to undergo early coronary revascularization.
Journal ArticleDOI
The year in non-ST-segment elevation acute coronary syndrome.
TL;DR: Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and NSTE-MI, which comprises unstable angina and non- ST-se segment elevation myocardial infarction, accounted for approximately 1.7 million discharges from U.S. hospitals in 2002.
Journal ArticleDOI
Economic Evaluation of Bivalirudin With or Without Glycoprotein IIb/IIIa Inhibition Versus Heparin With Routine Glycoprotein IIb/IIIa Inhibition for Early Invasive Management of Acute Coronary Syndromes
Duane S. Pinto,Duane S. Pinto,Gregg W. Stone,Chunxue Shi,Elizabeth Schneider Dunn,Matthew R. Reynolds,Matthew R. Reynolds,Meghan York,Joshua Walczak,Ronna H. Berezin,Roxana Mehran,Brent T. McLaurin,David A. Cox,E. Magnus Ohman,A. Michael Lincoff,David J. Cohen,Acuity (Acute Catheterization),Urgent Intervention Triage Strategy Investigators +17 more
TL;DR: Bivalirudin monotherapy seems to be an economically attractive alternative to heparin + GPI for patients with moderate- and high-risk NSTE-ACS, with similar protection from ischemic events, reduced bleeding, and shorter length of stay.
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