1. Updating the chest pain algorithm: incorporating new evidence.
- Author
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Goyal N, Stant J, Esposito F, Piri G, Collins M, Sayan O, Neuberg G, Miller L, Moses JW, Stone GW, Giglio J, and Rabbani LE
- Subjects
- Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome mortality, Acute Coronary Syndrome therapy, Angina, Unstable diagnosis, Angina, Unstable mortality, Angina, Unstable therapy, Chest Pain diagnosis, Chest Pain mortality, Combined Modality Therapy, Critical Pathways standards, Evidence-Based Medicine, Female, Forecasting, Humans, Male, Myocardial Infarction diagnosis, Myocardial Infarction mortality, Myocardial Infarction therapy, Prognosis, Randomized Controlled Trials as Topic, Risk Assessment, Survival Analysis, Treatment Outcome, United States, Algorithms, Chest Pain therapy, Critical Pathways trends, Myocardial Revascularization methods, Thrombolytic Therapy methods
- Abstract
In 2003, we published our chest pain protocol for the management of acute coronary syndromes (ACSs) and acute myocardial infarction. Our algorithm was specifically designed for our institution, which was primary percutaneous coronary intervention (PCI) for all ST-elevation myocardial infarctions (STEMIs) and a preferred invasive approach for non-STEMIs. Since 2003, there have been numerous changes in the adjunctive pharmacotherapeutic armamentarium for PCI in both the STEMI and non-STEMI ACS context. We present our updated chest pain algorithm with a brief review of the rapidly evolving changes in adjunctive pharmacotherapy for PCI and provide a rationale for the changes that we have made to our institutional protocol. Clinical pathways need to be consistently updated and revises by incorporating new evidence from clinical trials in order to maintain clinical relevance.
- Published
- 2008
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