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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From guidelines to clinical practice: the impact of hospital and geographical characteristics on temporal trends in the management of acute coronary syndromes. The Global Registry of Acute Coronary Events (GRACE).
Keith A.A. Fox,Shaun G. Goodman,Frederick A. Anderson,Christopher B. Granger,Mauro Moscucci,Marcus Flather,Frederick A. Spencer,Andrzej Budaj,Omar H. Dabbous,Joel M. Gore +9 more
TL;DR: Hospital and geographical factors appear to have a marked influence on the uptake of evidence-based therapies in ACS management, and antithrombotic and interventional therapies changed markedly over time and were profoundly influenced by hospital and geographic characteristics.
Journal ArticleDOI
Application of the TIMI risk score for unstable angina and non-ST elevation acute coronary syndrome to an unselected emergency department chest pain population.
TL;DR: The TIMI risk score may be a useful tool for risk stratification of ED patients with chest pain syndrome and had similar performance characteristics to that seen when applied to other databases of patients enrolled in clinical trials and registries using a 14-day end point.
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Physician decision making and cardiac risk: Effects of knowledge, risk perception, risk tolerance, and fuzzy processing.
TL;DR: Judges and decisions for 9 hypothetical patients at 3 levels of cardiac risk were investigated, comparing student and physician groups varying in domain-specific knowledge and confirming fuzzy-trace theory.
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Efficacy and Safety of Adjusted-Dose Prasugrel Compared With Clopidogrel in Japanese Patients With Acute Coronary Syndrome:– The PRASFIT-ACS Study –
Shigeru Saito,Takaaki Isshiki,Takeshi Kimura,Hisao Ogawa,Hiroyoshi Yokoi,Shinsuke Nanto,Morimasa Takayama,Kazuo Kitagawa,Masakatsu Nishikawa,Shunichi Miyazaki,Masato Nakamura +10 more
TL;DR: Prasugrel 20/3.75mg was associated with a low incidence of ischemic events, similar to the results of TRITON-TIMI 38, and with aLow risk of clinically serious bleeding in Japanese ACS patients.
Journal ArticleDOI
2012 update to the Society of Thoracic Surgeons guideline on use of antiplatelet drugs in patients having cardiac and noncardiac operations.
Victor A. Ferraris,Sibu P. Saha,Julie H. Oestreich,Howard K. Song,Todd K. Rosengart,T. Brett Reece,C. David Mazer,Charles R. Bridges,George J. Despotis,Kanae Jointer,Ellen R. Clough +10 more
TL;DR: This research presents a novel and scalable approach called “SmartCardiothoracicSurgery,” which aims to provide real-time information about the dynamic response of the immune system to heart attack and stroke.
References
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