Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non–ST-Elevation Acute Coronary Syndromes:

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

This clinical policy from the American College of Emergency Physicians addresses key issues in the evaluation and management of patients with suspected non–ST-elevation acute coronary syndromes. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) In adult patients without evidence of ST-elevation acute coronary syndrome, can initial risk stratification be used to predict a low rate of 30-day major adverse cardiac events? (2) In adult patients with suspected acute non–ST-elevation acute coronary syndrome, can troponin testing within 3 hours of emergency department presentation be used to predict a low rate of 30-day major adverse cardiac events? (3) In adult patients with suspected non–ST-elevation acute coronary syndrome in whom acute myocardial infarction has been excluded, does further diagnostic testing (eg, provocative, stress test, computed tomography angiography) for acute coronary syndrome prior to discharge reduce 30-day major adverse cardiac events? (4) Should adult patients with acute non–ST-elevation myocardial infarction receive immediate antiplatelet therapy in addition to aspirin to reduce 30-day major adverse cardiac events? Evidence was graded and recommendations were made based on the strength of the available data.

Original languageEnglish (US)
Pages (from-to)e65-e106
JournalAnnals of Emergency Medicine
Volume72
Issue number5
DOIs
StatePublished - Nov 1 2018

Fingerprint

Acute Coronary Syndrome
Hospital Emergency Service
Myocardial Infarction
Troponin
Exercise Test
Aspirin
Therapeutics

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non–ST-Elevation Acute Coronary Syndromes: (2018). Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes. Annals of Emergency Medicine, 72(5), e65-e106. https://doi.org/10.1016/j.annemergmed.2018.07.045

Clinical Policy : Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes. / American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non–ST-Elevation Acute Coronary Syndromes:.

In: Annals of Emergency Medicine, Vol. 72, No. 5, 01.11.2018, p. e65-e106.

Research output: Contribution to journalReview article

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non–ST-Elevation Acute Coronary Syndromes: 2018, 'Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes', Annals of Emergency Medicine, vol. 72, no. 5, pp. e65-e106. https://doi.org/10.1016/j.annemergmed.2018.07.045
American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non–ST-Elevation Acute Coronary Syndromes:. Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes. Annals of Emergency Medicine. 2018 Nov 1;72(5):e65-e106. https://doi.org/10.1016/j.annemergmed.2018.07.045
American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non–ST-Elevation Acute Coronary Syndromes:. / Clinical Policy : Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes. In: Annals of Emergency Medicine. 2018 ; Vol. 72, No. 5. pp. e65-e106.
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abstract = "This clinical policy from the American College of Emergency Physicians addresses key issues in the evaluation and management of patients with suspected non–ST-elevation acute coronary syndromes. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) In adult patients without evidence of ST-elevation acute coronary syndrome, can initial risk stratification be used to predict a low rate of 30-day major adverse cardiac events? (2) In adult patients with suspected acute non–ST-elevation acute coronary syndrome, can troponin testing within 3 hours of emergency department presentation be used to predict a low rate of 30-day major adverse cardiac events? (3) In adult patients with suspected non–ST-elevation acute coronary syndrome in whom acute myocardial infarction has been excluded, does further diagnostic testing (eg, provocative, stress test, computed tomography angiography) for acute coronary syndrome prior to discharge reduce 30-day major adverse cardiac events? (4) Should adult patients with acute non–ST-elevation myocardial infarction receive immediate antiplatelet therapy in addition to aspirin to reduce 30-day major adverse cardiac events? Evidence was graded and recommendations were made based on the strength of the available data.",
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