It is important that the medical profession play a
significant role in critically evaluating the use of
diagnostic procedures and therapies in the management
and prevention of disease. Rigorous and expert analysis
of the available data documenting relative benefits
and risks of those procedures and therapies can produce
helpful guidelines that improve the effectiveness of
care, optimize patient outcomes, and favorably impact
the overall cost of care by focusing resources on the
most effective strategies.
The American College of Cardiology (ACC) and the American
Heart Association (AHA) have jointly engaged in the
preparation of such guidelines in the area of cardiovascular
disease since 1980. This effort is directed by the ACC/AHA
Task Force on Practice Guidelines, which is charged
with developing and revising practice guidelines for
important cardiovascular diseases and procedures. Experts
in the subject under consideration are selected from
involved organizations to examine subject-specific data
and write guidelines. The process includes additional
representatives from other medical practitioner and
specialty groups where appropriate. Writing groups are
specifically charged to perform a formal literature
review, weigh the strength of evidence for or against
a particular treatment or procedure, and include estimates
of expected-health outcomes in areas where data exist.
Patient-specific modifiers, comorbidities, and issues
of patient preference that might influence the choice
of particular tests or therapies are considered, along
with frequency of follow-up and cost-effectiveness.
The ACC/AHA Task Force on Practice Guidelines makes
every effort to avoid any actual or potential conflicts
of interest that might arise as a result of an outside
relationship or personal interest of a member of the
writing panel. Specifically, all members of the writing
panel are asked to provide disclosure statements of
all such relationships that might be perceived as real
or potential conflicts of interest. These statements
are reviewed by the parent task force, reported orally
to all members of the writing panel at the first meeting,
and updated as changes occur.
These practice guidelines are intended to assist physicians
and other healthcare providers in clinical decision
making by describing a range of generally acceptable
approaches for the diagnosis, management, or prevention
of specific diseases or conditions. These guidelines
attempt to define practices that meet the needs of most
patients in most circumstances. The ultimate judgment
regarding care of a particular patient must be made
by the physician and patient in light of circumstances
specific to that patient.
This committee includes cardiologists with and without
involvement in interventional procedures, a cardiac
surgeon, and an official representative from the Society
for Cardiac Angiography and Interventions. This document
was reviewed by 3 official reviewers nominated by ACC,
3 official reviewers nominated by AHA, the AHA Committee
on Diagnostic and Interventional Cardiac Catheterization,
the ACC Interventional Database Committee, the ACC Cath
Lab Accreditation Working Group, the ACC Cardiac Catheterization
Committee, the Society for Cardiac Angiography and Interventions,
and 21 outside reviewers nominated by the Writing Committee.
This document was approved for publication by the governing
bodies of ACC and AHA and officially endorsed by the
Society of Cardiac Angiography and Interventions (SCA&I).
These guidelines will be considered current unless the
Task Force revises them or withdraws them from distribution.
