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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Journal ArticleDOI
An Early and Simple Predictor of Severe Left Main and/or Three-Vessel Disease in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome
Masami Kosuge,Toshiaki Ebina,Kiyoshi Hibi,Satoshi Morita,Mitsuaki Endo,Nobuhiki Maejima,Noriaki Iwahashi,Kozo Okada,Toshiyuki Ishikawa,Satoshi Umemura,Kazuo Kimura +10 more
TL;DR: ST-segment elevation ≥1.0 mm in lead aVR on admission electrocardiogram is highly suggestive of severe LM/3VD in patients with NSTE-ACS, and selected patients with this finding might benefit from promptly undergoing angiography, withholding clopidogrel to allow early CABG.
Journal ArticleDOI
Targeting outpatient drug safety: recommendations of the Dutch HARM-Wrestling Task Force.
Margaretha F. Warlé-van Herwaarden,Cees Kramers,Miriam C. J. M. Sturkenboom,Patricia M. L. A. van den Bemt,Patricia M. L. A. van den Bemt,Peter A. G. M. De Smet +5 more
TL;DR: The aim of the study was to identify the most relevant ADEs and to develop a limited number of recommendations for concrete interventions, which should be feasible and relatively easy to convert into computerized drug safety alerts.
In-Hospital Initiation of Lipid-Lowering Therapy After Coronary Intervention as a Predictor of Long-term Utilization
Herbert D. Aronow,Gian M. Novaro,Michael S. Lauer,Danielle M. Brennan,A. Michael Lincoff,Eric J. Topol,Dean J. Kereiakes,Steven E. Nissen +7 more
TL;DR: Inpatient initiation of lipid-lowering therapy appears to be an effective strategy for bridging the gap between current medical knowledge and practice, with patients who start taking lipid- Lowering therapy before hospital discharge nearly 3 times as likely to be taking these agents 6 months later.
Journal ArticleDOI
High-risk patients with acute coronary syndromes treated with low-molecular-weight or unfractionated heparin - Outcomes at 6 months and 1 year in the SYNERGY trial
Kenneth W. Mahaffey,Marc Cohen,Jyotsna Garg,Elliott M. Antman,Neal S. Kleiman,Shaun G. Goodman,Lisa G. Berdan,Craig J. Reist,Anatoly Langer,Harvey D. White,Philip E. Aylward,Jacques Col,James J. Ferguson,Robert M. Califf +13 more
TL;DR: The SYNERGY trial showed that enoxaparin was not inferior to unfractionated heparin in reducing death or nonfatal myocardial infarction (MI) at 30 days, and patients continued to experience adverse cardiac events through long-term follow-up.
Journal ArticleDOI
Discovery of proteins related to coronary artery disease using industrial-scale proteomics analysis of pooled plasma.
Mark P. Donahue,Keith Rose,Denis Hochstrasser,Jacky Vonderscher,Peter Grass,Salah-Dine Chibout,Charlotte L. Nelson,Peter Sinnaeve,Pascal J. Goldschmidt-Clermont,Christopher B. Granger +9 more
TL;DR: A large number of proteins that differ in abundance in populations with and those without angiographic coronary disease are identified and comprise candidates for validation studies in individual patients and in larger clinical data sets to better define disease pathways and establish novel markers for disease.
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