ACC/AHA Guideline Update for the Management of Patients With Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction—2002: Summary Article

Braunwald, Eugene; Beasley, John W.; Califf, Robert M.; Cheitlin, M.D.; Hochman, Judith S.; Jones, Robert H.; Kereiakes, Dean J.; Kupersmith, Joel; Levin, Thomas N.; Pepine, Carl J.; Schaeffer, John W.; Smith, E. L.; Steward, David E.; Théroux, Pierre; Gibbons, Raymond J.; Antman, Elliott M.; Alpert, Joseph S.; Faxon, David P.; Fuster, Valentín; Gregoratos, Gabriel; Hiratzka, Loren F.; Jacobs, Alice K.; Smith, Sidney C.

doi:10.1161/01.cir.0000037106.76139.53

Cited by 841 publications

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“…19 Abbreviations: ACE = angiotensin-converting enzyme; CABG = coronary artery bypass graft; GP = glycoprotein; PCI = percutaneous coronary intervention. Data are presented as percentages.…”

Section: Discussionmentioning

confidence: 99%

Influence of Clinical Trial Participation on Subsequent Antithrombin Use

Shah

Peterson

Chen

et al. 2010

Clinical Cardiology

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BackgroundResults from the Superior Yield of the New Strategy of Enoxaparin, Revascularization, and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) trial showed that the low‐molecular‐weight heparin (LMWH) enoxaparin was non‐inferior compared with unfractionated heparin (UFH) in patients with non‐ST‐elevation acute coronary syndromes (NSTE‐ACS) managed invasively.HypothesisWe explored the influence of SYNERGY trial site participation on subsequent patterns of heparin use for NSTE‐ACS patients treated in routine practice.MethodsWe examined temporal patterns of LMWH use compared with UFH use among 122 764 patients with NSTE‐ACS enrolled in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) quality improvement initiative between January 1, 2002 and June 30, 2006, to determine whether site participation in SYNERGY influenced the type of heparin used before and after publication of the SYNERGY results in July 2004.ResultsA total of 118 out of 388 (30%) U.S. hospitals participating in CRUSADE simultaneously participated in SYNERGY. SYNERGY sites in the CRUSADE registry were more likely to have a teaching affiliation and have more hospital beds than non‐SYNERGY centers in the registry. There was no difference in the proportion of patients treated with LMWH at SYNERGY and non‐SYNERGY sites prior to July 2004 compared with after July 2004. However, at SYNERGY sites, there was a slight decrease in the proportion of patients treated with both UFH and LMWH within 24 hours of presentation.ConclusionsThe results of the SYNERGY trial did not appear to influence temporal patterns of LMWH use at sites in the CRUSADE registry. Furthermore, site participation in the SYNERGY trial did not alter patterns of LMWH use for NSTE‐ACS after publication of the trial results in July 2004. Copyright © 2009 Wiley Periodicals, Inc.

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“…19 Abbreviations: ACE = angiotensin-converting enzyme; CABG = coronary artery bypass graft; GP = glycoprotein; PCI = percutaneous coronary intervention. Data are presented as percentages.…”

Section: Discussionmentioning

confidence: 99%

Influence of Clinical Trial Participation on Subsequent Antithrombin Use

Shah

Peterson

Chen

et al. 2010

Clinical Cardiology

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“…Most of the bleeding occurred during the first month of treatment and was related to the ASA dose more than to the combined treatment. Intravenous GP IIb/IIIa inhibitors (either tirofiban or eptifibatide) are recommended by the American College of Cardiology and the American Heart Association guidelines (14) for the early treatment of high-risk patients with non-STsegment elevation ACS if cardiac catheterization or PCI is planned.…”

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confidence: 99%

The impact of bleeding in patients with acute coronary syndromes: How to optimize the benefits of treatment and minimize the risk

Fitchett

2007

Canadian Journal of Cardiology

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“…E vidence from the literature recommends an early invasive strategy for patients with high-risk unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI) (1,2). However, the application of this strategy for patients from community hospitals has been limited by the availability of tertiary care facilities and long waiting lists.…”

mentioning

confidence: 99%