美国心脏病学会/美国心脏协会与欧洲心脏病学会关于非ST段抬高型急性冠状动脉综合征患者管理指南的比较。

Comparison of the American College of Cardiology/American Heart Association and the European Society of Cardiology guidelines for the management of patients with non-ST-segment elevation acute coronary syndromes.

作者信息

Alame Aya J, Karatasakis Aris, Karacsonyi Judit, Danek Barbara A, Resendes Erica, Martinez Parachini Jose R, Kalsaria Pratik, Roesle Michele, Rangan Bavana V, Sorajja Paul, Jneid Hani, Banerjee Subhash, Brilakis Emmanouil S

机构信息

aVA North Texas Healthcare System, UT Southwestern Medical Center, Dallas bMichael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas cAbbott Northwestern Hospital, Minneapolis Heart Institute, Minneapolis, Minnesota, USA.

出版信息

Coron Artery Dis. 2017 Jun;28(4):294-300. doi: 10.1097/MCA.0000000000000472.

DOI:10.1097/MCA.0000000000000472

PMID:28306587

Abstract

INTRODUCTION

The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) have been developing guidelines to assist clinicians in making evidence-based decisions.

MATERIALS AND METHODS

The current ACC/AHA and ESC guidelines for non-ST-segment elevation acute coronary syndromes (NSTE-ACS) that were updated in 2014 and 2015, respectively, were compared to assess the number of recommendations on the basis of class of recommendation and level of evidence (LOE), the sources cited, and the content.

RESULTS

The total number of recommendations in the ACC/AHA and ESC guidelines was 182 and 147, respectively. The recommendation class distribution of the ACC/AHA guidelines was 61.0% class I (compared with 61.9% in the ESC guidelines, P=0.865), 29.7% class II (compared with 32.0% in the ESC guidelines, P=0.653), and 9.3% class III (compared with 6.1% in the ESC guidelines, P=0.282). The LOE distribution among ACC/AHA guidelines was 15.9% LOE A (compared with 27.9% in the ESC guidelines, P=0.008), 50.0% LOE B (compared with 33.3% in the ESC guidelines, P=0.002), and 34.1% LOE C (compared with 38.8% in the ESC guidelines, P=0.377). The ACC/AHA guidelines cited 827 publications and the ESC guidelines cited 551 publications, 124 of which were shared by both sets of guidelines. The guidelines' approaches to NSTE-ACS were consistent, with minor differences in diagnostic and medical therapy recommendations.

CONCLUSION

Overall, the ACC/AHA and ESC guidelines contain a comparable number of recommendations and provide similar guidance for the management of patients with NSTE-ACS.

摘要

引言

美国心脏病学会（ACC）、美国心脏协会（AHA）和欧洲心脏病学会（ESC）一直在制定指南，以协助临床医生做出基于证据的决策。

材料与方法

对分别于2014年和2015年更新的当前ACC/AHA和ESC关于非ST段抬高型急性冠状动脉综合征（NSTE-ACS）的指南进行比较，以根据推荐类别和证据水平（LOE）、引用的来源及内容评估推荐意见的数量。

结果

ACC/AHA和ESC指南中的推荐意见总数分别为182条和147条。ACC/AHA指南的推荐类别分布为：I类61.0%（ESC指南中为61.9%，P=0.865），II类29.7%（ESC指南中为32.0%，P=0.653），III类9.3%（ESC指南中为6.1%，P=0.282）。ACC/AHA指南中的LOE分布为：A级15.9%（ESC指南中为27.9%，P=0.008），B级50.0%（ESC指南中为33.3%，P=0.002），C级34.1%（ESC指南中为38.8%，P=0.377）。ACC/AHA指南引用了827篇出版物，ESC指南引用了551篇出版物，其中124篇为两组指南共同引用。指南对NSTE-ACS的处理方法一致，在诊断和药物治疗推荐方面存在细微差异。