Focused Update of the ACCF/AHA Guidelines for UA/NSTEMI Released
On July 16, the ACC Foundation (ACCF) and the American Heart Association (AHA) released a focused update of the guideline for the management of patients with unstable angina (UA)/non-ST-elevation myocardial infarction (NSTEMI).
The document, which addresses recent research and approvals of new drugs like ticagrelor, updates sections of the original 2007 guideline and replaces the 2011 Focused Update. While the updated guideline continues to recommend that all patients receive aspirin immediately after hospitalization, and continue as long as it is tolerated, other key recommendations include:
"The AHA and ACCF constantly update their guidelines so that physicians can provide patients with the most appropriate, aggressive therapy with the goal of improving health and survival," said Hani Jneid, MD, FACC, lead author of the update and an assistant professor of medicine and director of interventional cardiology research at Baylor College of Medicine, and an interventional cardiologist at the Michael E. DeBakey VA Medical Center in Houston. In the case of this update "we have put [ticagrelor] on equal footing with the two other antiplatelet medications, clopidogrel and prasugrel."
Also included in the update, the guideline authors encourage clinicians and hospitals to participate in a standardized quality-of-care data registry designed to track and measure outcomes, complications and adherence to evidence-based recommendations. They note that these registries "may prove pivotal in addressing opportunities for quality improvement at the local, regional and national level, and include the elimination of health care disparities and conduct of comparative effectiveness research."
The document was endorsed by the American College of Emergency Physicians, Society for Cardiovascular Angiography Interventions, and Society of Thoracic Surgeons.
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