ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction—Executive Summary

Anderson, Jeffrey L.; Adams, Cynthia D.; Antman, Elliott M.; Bridges, Charles R.; Califf, Robert M.; Casey, Donald E.; Chavey, William E.; Fesmire, Francis M.; Hochman, Judith S.; Levin, Thomas N.; Lincoff, A. Michael; Peterson, Eric D.; Théroux, Pierre; Wenger, Nanette K.; Wright, R. Scott

doi:10.1016/j.jacc.2007.02.028

Cited by 241 publications

(44 citation statements)

References 385 publications

(242 reference statements)

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“…[13][14][15][16][17][18][19] The 2010 retrospective registry data were used to adjust the measurement set to the existing registry structure. In 2010, 2275 AMI patients were included in the registry by 39 hospitals and amongst them 9 had a round the clock catheter laboratory (CathLab) service available.…”

Section: Development Of the Measurements Based On Evidence-based Recomentioning

confidence: 99%

Impact of new health care policies on the quality of acute myocardial infarction treatment in Swiss hospitals: A before and after observational study

Dorey

Puhan

Biller‐Andorno

2016

JHA

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Objective: Following a revision of the Swiss Federal Health Insurance Act, the regional hospital planning structure was modified and the hospital financing organized at a national level with the use of diagnosis related groups (SwissDRGs). The aim of this observational study was to determine in an independent way the initial impact of these changes on the quality of hospital treatment, with patients hospitalized for Acute Myocardial Infarction (AMI) being the chosen study group. Methods: We used prospective data from a Swiss clinical registry for AMI. The quality was measured based on the adherence to 10 evidence-based performance indicators for AMI treatment, and on the evaluation of in-hospital outcomes (mortality, complications, length of hospital stay [LOS]) globally and for seven pre-defined vulnerable subgroups. The study compared patient-based data before (2011) and after (2012) the implementation of the reform. Results: The study included 33 matched hospitals, and compared the AMI treatment of 2,491 patients in 2011 (before) and 2,544 in 2012 (after the hospital reform). No significant changes in the evidence-based performance indicators were observed, but an on average one day reduction in the LOS and worse outcomes in one of the pre-defined group of patients were found. The issue of how the clinical team achieved these results was not directly explored due to the underlying registry's unalterable structure. Conclusions: One year after the implementation of a new hospital financing system in Switzerland, the quality of treatment delivered to patients hospitalized for AMI was maintained overall. The worse in-hospital mortality in one pre-defined vulnerable subgroup could reflect the emergence of difficulties for clinical teams to cope with patients demanding extra care and time. Further investigation is warranted.

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Section: Development Of the Measurements Based On Evidence-based Recomentioning

confidence: 99%

Impact of new health care policies on the quality of acute myocardial infarction treatment in Swiss hospitals: A before and after observational study

Dorey

Puhan

Biller‐Andorno

2016

JHA

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“…Features that make a diagnosis of ACS likely include: central (retro sternal) location; sudden or acute onset; heavy or burning sensation with radiation to the arm or jaw; associated dyspnoea, nausea or sweating; duration >15 minutes; relief of symptoms by nitrates; worsening of symptoms by activity; chest or leftarm discomfort that is the same in nature as previously documented angina; and a known history of CAD (including prior MI). [3] Atypical presentations need to be considered in the elderly, diabetics and women.…”

Section: Historymentioning

confidence: 99%

“…ACS is less likely if the presenting chest pain is reproducible by chest palpation. [3] Examination of the respiratory system should exclude …”

Section: Physical Examinationmentioning

confidence: 99%

Approach to chest pain and acute myocardial infarction

et al. 2015

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“…The pain oftentimes is diffuse and may be accompanied by nausea, vomiting, diaphoresis or shortness of breath [10]. Because symptoms are varied and non-specific especially in the elderly and those with other comorbidities such as diabetes and chronic lung disease, up to 75% of patients evaluated in the ED for ACS are found not to have acute ischemia [11]. This percentage is even higher once one removes high-risk patients such as those with overt disease such as ST elevation MI (STEMI) and those who are hemodynamically unstable.…”

Section: Introductionmentioning

confidence: 99%

“…The emergency physician must interpret the cardiac biomarker results in the context of the patient's history, physical examination, and electrocardiogram (ECG) to reach a diagnosis (e.g., non-cardiac diagnosis, chronic stable angina, possible ACS, and definite ACS). Those patients with definite ACS are further sub-divided into unstable angina, non-ST segment elevation MI (NSTEMI), and STEMI [11]. As its name implies, the diagnosis of STEMI is made via ECG findings.…”

Section: Introductionmentioning

confidence: 99%

Identification of myocardial injury in the emergency setting

Kavsak

Worster

You

et al. 2010

Clinical Biochemistry

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Within the past decade, the use of biomarkers to detect myocardial injury in the emergency department (ED) has been given increasing prominence as evident by the numerous studies and guidelines documenting their use. This review details the scope of the clinical problem, the history of changes in the definition of myocardial infarction (MI) and the new approaches, as well as suggestions for using laboratory biomarkers in the early detection of MI in the ED.

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ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction—Executive Summary

Cited by 241 publications

References 385 publications

Impact of new health care policies on the quality of acute myocardial infarction treatment in Swiss hospitals: A before and after observational study

Impact of new health care policies on the quality of acute myocardial infarction treatment in Swiss hospitals: A before and after observational study

Approach to chest pain and acute myocardial infarction

Identification of myocardial injury in the emergency setting

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