New appropriate use criteria for coronary revascularization released
The American College of Cardiology, along with several partnering organizations, today released updated appropriate use criteria for performing coronary revascularization in patients with acute coronary syndromes.
Patients with acute coronary syndromes suffer from sudden, reduced blood flow to the heart, requiring quick diagnosis and care. Coronary revascularization is the restoration of this blood flow to the heart commonly by coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI).
The appropriate use criteria document includes clinical scenarios developed to mimic patient presentations that may be encountered in everyday practice and information on symptom status, presence of clinical instability or ongoing ischemic symptoms, prior reperfusion therapy, risk level as assessed by noninvasive testing, fractional flow reserve testing, and coronary anatomy.
"This update provides a reassessment of clinical scenarios that the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria," said Manesh R. Patel, MD, FACC, FAHA, FSCAI, chief of the division of cardiology and co-director of the Duke Heart Center at Duke University and chair of the writing committee for the document. "The primary objective of the appropriate use criteria is to provide a framework for the assessment of practice patterns that will hopefully improve physician decision making and ultimately lead to better patient outcomes."
The clinical scenarios are scored to indicate whether revascularization is appropriate, may be appropriate or is rarely appropriate for the clinical scenario presented.
The document can be used as a clinical tool to assist clinicians in evaluating therapies and can help to better inform patients about their treatment options. It is important for patients to discuss revascularization and engage in shared decision making with their provider to come to a decision on the best treatment plan.
The writing committee stresses that the criteria should be used as an overall guide, and physicians should evaluate each case on an individual basis.
These appropriate use criteria are a product of a partnership between the ACC, the American Association for Thoracic Surgery, the American Heart Association, American Society of Echocardiography, the American Society of Nuclear Cardiology, the Society for Cardiovascular Angiography and Interventions, the Society of Cardiovascular Computed Tomography and the Society of Thoracic Surgeons. The document is part one of a two-part revision for coronary revascularization. The updated appropriate use criteria for coronary revascularization in patients with stable ischemic heart disease are forthcoming.
The ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes will publish online today in the Journal of the American College of Cardiology.
About the American College of Cardiology
The American College of Cardiology is a 52,000-member medical society that is the professional home for the entire cardiovascular care team. The mission of the College is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, standards and guidelines. The College operates national registries to measure and improve care, offers cardiovascular accreditation to hospitals and institutions, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications. For more, visit acc.org.
About the American Heart Association
The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation's oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.
About the American Society of Echocardiography
As the largest global organization for cardiovascular ultrasound imaging, the American Society of Echocardiography (ASE) is the leader and advocate, setting practice standards and guidelines. Comprised of nearly 17,000 physicians, sonographers, nurses, and scientists, ASE is a strong voice providing guidance, expertise, and education to its members. The Society has a commitment to improving the practice of ultrasound and imaging of the heart and cardiovascular system for better patient outcomes. For more information about ASE, visit ASEcho.org.
About the American Society of Nuclear Cardiology
The American Society of Nuclear Cardiology ASNC is the recognized leader in quality, education, advocacy and standards in cardiovascular imaging, with nearly 4,000 members worldwide. ASNC is the only society dedicated solely to advocacy issues that impact the field of nuclear cardiology and is working with success to influence regulations to fight onerous private health plan policies — adverting reimbursement declines and fighting for improved payment and coverage. ASNC is dedicated to continuous quality improvement, education and patient-centered imaging, illustrating the ongoing commitment as a leader in the field of nuclear imaging and improving patient outcomes. ASNC establishes standards for excellence in cardiovascular imaging through the development of clinical guidelines, professional education, advocacy and research development. ASNC's members are comprised of cardiologists, radiologists, physicians, scientists, technologists, imaging specialists and other professionals committed to the science and practice of nuclear cardiology. http://www.asnc.org
About the Society for Cardiovascular Angiography and Interventions
The Society for Cardiovascular Angiography and Interventions is a 4,300-member professional organization representing invasive and interventional cardiologists in approximately 70 nations. SCAI's mission is to promote excellence in invasive/interventional cardiovascular medicine through physician and allied health professional education and representation, and advancement of quality standards to enhance patient care. For more information about SCAI, visit http://www.SCAI.org.
About the Society of Cardiovascular Computed Tomography
SCCT is the international professional society representing physicians, scientists and technologists advocating for research, education and clinical excellence in the use of cardiovascular computed tomography. Our goal is to build a strong national and international membership body of physicians, scientists, technologists, administrators, and other individuals with interest in clinical applications or research in cardiovascular CT, and to develop evidence-based standards, guidelines, and recommendations relative to the clinical utilization of cardiovascular CT. Learn more at http://www.scct.org!
About The Society of Thoracic Surgeons
Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 7,400 cardiothoracic surgeons, researchers, and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society's mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.