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

Publication ,  Journal Article
American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non–ST-Elevation Acute Coronary Syndromes:, ...
Published in: Ann Emerg Med
November 2018

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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Published In

Ann Emerg Med

DOI

EISSN

1097-6760

Publication Date

November 2018

Volume

72

Issue

5

Start / End Page

e65 / e106

Location

United States

Related Subject Headings

  • Troponin
  • ST Elevation Myocardial Infarction
  • Risk Assessment
  • Practice Guidelines as Topic
  • Male
  • Humans
  • Female
  • Emergency Treatment
  • Emergency Service, Hospital
  • Emergency & Critical Care Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non–ST-Elevation Acute Coronary Syndromes:, ., Tomaszewski, C. A., Nestler, D., Shah, K. H., Sudhir, A., & Brown, M. D. (2018). Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non-ST-Elevation Acute Coronary Syndromes. Ann Emerg Med, 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:, Michael D., Christian A. Tomaszewski, David Nestler, Kaushal H. Shah, Amita Sudhir, and Michael D. Brown. “Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non-ST-Elevation Acute Coronary Syndromes.Ann Emerg Med 72, no. 5 (November 2018): e65–106. 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:, Tomaszewski CA, Nestler D, Shah KH, Sudhir A, Brown MD. Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non-ST-Elevation Acute Coronary Syndromes. Ann Emerg Med. 2018 Nov;72(5):e65–106.
American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non–ST-Elevation Acute Coronary Syndromes:, Michael D., et al. “Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non-ST-Elevation Acute Coronary Syndromes.Ann Emerg Med, vol. 72, no. 5, Nov. 2018, pp. e65–106. Pubmed, doi: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:, Tomaszewski CA, Nestler D, Shah KH, Sudhir A, Brown MD. Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non-ST-Elevation Acute Coronary Syndromes. Ann Emerg Med. 2018 Nov;72(5):e65–e106.
Journal cover image

Published In

Ann Emerg Med

DOI

EISSN

1097-6760

Publication Date

November 2018

Volume

72

Issue

5

Start / End Page

e65 / e106

Location

United States

Related Subject Headings

  • Troponin
  • ST Elevation Myocardial Infarction
  • Risk Assessment
  • Practice Guidelines as Topic
  • Male
  • Humans
  • Female
  • Emergency Treatment
  • Emergency Service, Hospital
  • Emergency & Critical Care Medicine