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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Co-localization of von Willebrand factor with platelet thrombi, tissue factor and platelets with fibrin, and consistent presence of inflammatory cells in coronary thrombi obtained by an aspiration device from patients with acute myocardial infarction
TL;DR: In spite of various limitations, the results contain information suggesting the possible role of VWF in platelet‐thrombus formation, possible important role played by tissue factor and activated platelets in the formation of fibrin fibrils, and the positive relationship between inflammatory cells migration and the Formation of occlusive thrombi in human coronary arteries.
Journal ArticleDOI
Association between bleeding, blood transfusion, and costs among patients with non-ST-segment elevation acute coronary syndromes.
Sunil V. Rao,Padma Kaul,Lawrence Liao,Paul W. Armstrong,E. Magnus Ohman,Christopher B. Granger,Robert M. Califf,Robert A. Harrington,Eric L. Eisenstein,Daniel B. Mark +9 more
TL;DR: The data suggest that strategies that reduce both ischemia and the risk for bleeding have the potential to produce important reductions in the costs of care for patients with NSTE ACS.
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Hypertension-related morbidity and mortality in African Americans--why we need to do better.
TL;DR: Comorbidities of high blood pressure and greater severity of hypertension contribute to a greater burden of hypertensive target organ damage in African Americans and may be a factor in the shorter life expectancy of this population compared with white Americans.
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Current role of beta-blockers in the treatment of hypertension
TL;DR: The key message of this paper is that atenolol should not be used as an antihypertensive drug and that the degree of reduction of mortality, myocardial infarction, stroke and congestive heart failure by anti Hypertensive therapy is dependent on thedegree of lowering of aortic blood pressure.
Journal ArticleDOI
Epidemiology of non-ST elevation acute coronary syndromes in the Italian cardiology network: the BLITZ-2 study.
Antonio Di Chiara,Claudio Fresco,Stefano Savonitto,Cesare Greco,Donata Lucci,Lucio Gonzini,Antonio Mafrici,Filippo Ottani,Leonardo Bolognese,Stefano De Servi,Alessandro Boccanelli,Aldo P. Maggioni,Francesco Chiarella +12 more
TL;DR: According to this, the nationwide registry outcome is only marginally influenced by invasive procedures and contemporary management of patients with NSTEACS in Italy is primarily driven by resource availability.
References
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