Bridging the Gap Between Scientific Evidence and Clinical Practice in the Management of Non-ST-segment Elevation Acute Coronary Syndromes

2008 ◽  
Vol 5 (1) ◽  
pp. 16-21
Author(s):  
Sandeep Nathan ◽  
Rajiv Swamy
Keyword(s):  
Clinical Practice ◽  
Acute Coronary Syndromes ◽  
Scientific Evidence ◽  
St Segment Elevation ◽  
St Segment ◽  
Coronary Syndromes

scholarly journals Critical appraisal of the 2020 ESC guideline recommendations on diagnosis and risk assessment in patients with suspected non-ST-segment elevation acute coronary syndrome

2021 ◽  
Author(s):  
Evangelos Giannitsis ◽  
Stefan Blankenberg ◽  
Robert H. Christenson ◽  
Norbert Frey ◽  
Stephan von Haehling ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Critical Appraisal ◽  
Scientific Evidence ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Scientific Support ◽  
Prognostic Assessment ◽  
St Segment ◽  
Coronary Syndromes ◽  
Esc Guidelines

AbstractMultiple new recommendations have been introduced in the 2020 ESC guidelines for the management of acute coronary syndromes with a focus on diagnosis, prognosis, and management of patients presenting without persistent ST-segment elevation. Most recommendations are supported by high-quality scientific evidence. The guidelines provide solutions to overcome obstacles presumed to complicate a convenient interpretation of troponin results such as age-, or sex-specific cutoffs, and to give practical advice to overcome delays of laboratory reporting. However, in some areas, scientific support is less well documented or even missing, and other areas are covered rather by expert opinion or subjective recommendations. We aim to provide a critical appraisal on several recommendations, mainly related to the diagnostic and prognostic assessment, highlighting the discrepancies between Guideline recommendations and the existing scientific evidence.

scholarly journals ANMCO POSITION PAPER: Timing of coronary angiography in non-ST-segment elevation acute coronary syndromes

2021 ◽  
Vol 23 (Supplement_C) ◽  
pp. C196-C203
Author(s):  
Adriano Murrone ◽  
Fortunato Scotto di Uccio ◽  
Vincenzo Amodeo ◽  
Nadia Aspromonte ◽  
Pasquale Caldarola ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Acute Coronary Syndromes ◽  
Scientific Evidence ◽  
Position Paper ◽  
St Segment Elevation ◽  
St Segment ◽  
Critical Issues ◽  
Coronary Syndromes ◽  
St Elevation ◽  
European Society Of Cardiology

Abstract The European Society of Cardiology guidelines on non-ST-elevation acute coronary syndromes suggest different temporal strategies for the angiographic study depending on the risk profile. The scientific evidence underlying the guideline recommendations and the critical issues currently existing in Italy, that often do not allow either an extended strategy of revascularization within 24 h or the application of the principle of the same day transfer from a spoke to a hub centre, are analysed. The position paper focuses, in particular, on the subgroup of patients with a defined diagnosis of non-ST-elevation myocardial infarction by proposing a timing of coronary angiography/revascularization that takes into account the available scientific evidence and the organizational possibilities of a considerable part of national cardiology services.

VALUE OF ST-SEGMENT ELEVATION IN LEAD AVR IN PREDICTING LEFT MAIN AND OR 3-VESSEL DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROMES

2017 ◽  
pp. 59-63
Author(s):  
Thanh Hung Dieu ◽  
Anh Vu Nguyen
Keyword(s):  
Predictive Value ◽  
Acute Coronary Syndromes ◽  
Independent Predictor ◽  
Left Main ◽  
St Segment Elevation ◽  
Vessel Disease ◽  
St Segment ◽  
Coronary Syndromes ◽  
Lead Avr ◽  
Sensitivity Specificity

Objects: We assessed the ability of ST-segment elevation in lead aVR to predict left main and/or 3-vessel disease (LM/3VD) in patients with acute coronary syndromes (ACS). Meterial and Method: 410 patients with ACS, who underwent coronary angiography, were evaluated. Results: 131 (31.9%) patients have been LM/3VD. ST segment elevation > 0.05 mV in leads aVR have been an independent predictor LM/3VD with sensitivity, specificity, positive predictive value PPV) and negative predictive value (NPV) 74.0%, 78.1%, 61.4% and 86.5%, respectively (p<0.001). ST segment elevation > 0.05 mV in leads aVR with ST segment depression in leads V4-V6 have related LM/3VD with sensitivity, specificity, PPV and NPV 44.3%, 92.8%, 74.4% and 75.2%, respectively (p<0.001). ST segment elevation > 0.1 mV in leads aVR have related LM/3VD with sensitivity, specificity, PPV and NPV 51.9%, 87.1%, 65.1% and 79.4%, respectively (p<0.001). Conclusions: ST segment elevation > 0.05 mV in leads aVR have been an independent predictor LM/3VD in patients with ACS. Key words: Acute coronary syndromes, ST-segment elevation, aVR

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