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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Identification of low responders to a 300-mg clopidogrel loading dose in patients undergoing coronary stenting
Dominick J. Angiolillo,Antonio Fernández-Ortiz,Esther Bernardo,Celia Ramírez,Carlos Felipe Barrera-Ramírez,Manel Sabaté,Rosana Hernández,Raúl Moreno,Javier Escaned,Fernando Alfonso,Camino Bañuelos,Marco A. Costa,Theodore A. Bass,Carlos Macaya +13 more
TL;DR: An increased GP IIb/IIIa activation before intervention may identify this group of patients suggesting the use of a more aggressive antithrombotic treatment in these individuals.
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Management Patterns in Relation to Risk Stratification Among Patients With Non–ST Elevation Acute Coronary Syndromes
Andrew T. Yan,Raymond T. Yan,Mary Tan,Anthony Fung,Eric A. Cohen,David Fitchett,Anatoly Langer,Shaun G. Goodman +7 more
TL;DR: Despite temporal increases in the use of cardiac catheterization and revascularization in the management of non-ST elevation ACSs, evidence-based invasive and pharmacological therapies remain paradoxically targeted toward low-risk patients.
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Severe pulmonary hypertension complicates postoperative outcome of non-cardiac surgery
TL;DR: PH is an important predictor of adverse cardiopulmonary outcome in non-cardiac surgery as reflected by markedly increased postoperative complications, especially in patients with coexistent high-risk clinical and surgical characteristics.
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Ninety-minute accelerated critical pathway for chest pain evaluation.
Siu Ming Ng,Padma Krishnaswamy,Robin Morissey,Paul Clopton,Robert L. Fitzgerald,Alan S. Maisel +5 more
TL;DR: A simple, inexpensive, yet aggressive critical pathway that utilizes high-risk features from clinical history, electrocardiographic changes, and rapid point-of-care testing of 3 cardiac markers allows for accurate triaging of chest pain patients within 90 minutes of presenting to the emergency department.
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