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2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR 胸痛评估与诊断指南:美国心脏病学会/美国心脏协会联合临床实践指南委员会的报告。

2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

出版信息

Circulation. 2021 Nov 30;144(22):e368-e454. doi: 10.1161/CIR.0000000000001029. Epub 2021 Oct 28.

Abstract

AIM

This clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients.

METHODS

A comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing randomized and nonrandomized trials, observational studies, registries, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, Agency for Healthcare Research and Quality reports, and other relevant databases. Additional relevant studies, published through April 2021, were also considered. Structure: Chest pain is a frequent cause for emergency department visits in the United States. The "2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain" provides recommendations based on contemporary evidence on the assessment and evaluation of chest pain. This guideline presents an evidence-based approach to risk stratification and the diagnostic workup for the evaluation of chest pain. Cost-value considerations in diagnostic testing have been incorporated, and shared decision-making with patients is recommended.

摘要

目的

本评估和诊断胸痛的临床实践指南为临床医生评估和诊断成年胸痛患者提供了建议和算法。

方法

从 2017 年 11 月 11 日至 2020 年 5 月 1 日,进行了全面的文献检索,包括随机和非随机试验、观察性研究、注册研究、综述以及其他在 PubMed、EMBASE、Cochrane 协作组织、美国医疗保健研究与质量局报告和其他相关数据库中以英文发表的人类受试者研究。还考虑了截至 2021 年 4 月发表的其他相关研究。结构:胸痛是美国急诊科就诊的常见原因。“2021 年美国心脏协会/美国心脏病学会/美国超声心动图学会/胸科医师学会/美国急诊医师学会/美国胸科学会/心血管磁共振学会胸痛评估和诊断指南”提供了基于当代胸痛评估和评估证据的建议。本指南提出了一种基于风险分层和胸痛评估诊断性检查的循证方法。已考虑到诊断测试的成本-价值因素,并建议与患者进行共同决策。

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