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
Reads0
Chats0
TLDR
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
Citations
More filters
Journal ArticleDOI
Pathophysiology and management of patients with chest pain and normal coronary arteriograms (cardiac syndrome X).
TL;DR: Patients with cardiac syndrome X (CSX)—typical chest pain and electrocardiographic changes suggestive of myocardial ischemia despite normal coronary arteriograms–represent a diagnostic and therapeutic riddle, and management strategies can improve the patient’s quality of life and reduce the financial burden imposed on health services.
Journal ArticleDOI
Plaque Volume and Occurrence and Location of Periprocedural Myocardial Necrosis After Percutaneous Coronary Intervention Insights From Delayed-Enhancement Magnetic Resonance Imaging, Thrombolysis in Myocardial Infarction Myocardial Perfusion Grade Analysis, and Intravascular Ultrasound
Italo Porto,Joseph B. Selvanayagam,William J. van Gaal,Francesco Prati,Adrian S. H. Cheng,Keith M. Channon,Stefan Neubauer,Adrian P. Banning +7 more
TL;DR: It is suggested that distal embolization of plaque material occurs in contemporary PCI of native coronary arteries and efforts to minimize procedural necrosis may require careful review of side branch anatomy and/or use of distal protection during extensive coronary stenting.
Journal ArticleDOI
Clopidogrel resistance: a new chapter in a fast-moving story.
TL;DR: Aspirin is effective in the short- and long-term prevention of adverse vascular events in high-risk patient groups, including those with ACS, stroke and peripheral arterial disease, and has been shown to reduce the frequency of ischemic complications after PCI.
Journal ArticleDOI
High-sensitive troponin T measurements: what do we gain and what are the challenges?
TL;DR: Recent multicentre studies have shown that hs-cTn assays improve the early diagnosis of patients with suspected AMI, particularly the early rule-out, and to achieve best clinical use, cTn has to be interpreted as a quantitative variable.
Journal ArticleDOI
Impact of Clopidogrel in Patients With Acute Coronary Syndromes Requiring Coronary Artery Bypass Surgery: A Multicenter Analysis
Jeffrey S. Berger,Carla B. Frye,Qing Harshaw,Fred H. Edwards,Steven R. Steinhubl,Richard C. Becker +5 more
TL;DR: Patients who undergo CABG within 5 days of receiving clopidogrel are at increased risk for reoperation, major bleeding, and increased length of stay, and these risks must be balanced by the clinical benefits of clopIDogrel use demonstrated in randomized clinical trials.
References
More filters
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.
Related Papers (5)
ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)
Elliott M. Antman,Daniel T. Anbe,Paul W. Armstrong,Eric R. Bates,Lee A. Green,Mary M. Hand,Judith S. Hochman,Harlan M. Krumholz,Frederick G. Kushner,Gervasio A. Lamas,Charles J. Mullany,Joseph P. Ornato,David L. Pearle,Michael A. Sloan,Sidney C. Smith,Joseph S. Alpert,Jeffrey L. Anderson,David P. Faxon,Valentin Fuster,Raymond J. Gibbons,Gabriel Gregoratos,Jonathan L. Halperin,Loren F. Hiratzka,Sharon A. Hunt,Alice K. Jacobs +24 more