Implications and Challenges Using Practice Guidelines for Chronic Angina
Authors: E. Magnus Ohman, Eric Peterson
Journal: Annals of Internal Medicine (2001)

Editorials2 October 2001Implications and Challenges Using Practice Guidelines for Chronic AnginaE. Magnus Ohman, MD and Eric Peterson, MDE. Magnus Ohman, MDDr. Ohman: University of North Carolina at Chapel Hill; Chapel Hill, NC 27599-7075Dr. Peterson: Duke Clinical Research Institute; Durham, NC 27705Search for more papers by this author and Eric Peterson, MDDr. Ohman: University of North Carolina at Chapel Hill; Chapel Hill, NC 27599-7075Dr. Peterson: Duke Clinical Research Institute; Durham, NC 27705Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-7-200110020-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Since 1980, the American College of Cardiology (ACC) and the American Heart Association (AHA) have jointly produced guidelines for the management of cardiovascular diseases. There are now approximately 25 such guidelines that define acceptable approaches to diagnosis and management of patients with heart disease. These guidelines are intended to assist physicians in defining the optimal range of practices for most patients with a given condition. It is also recognized that the ultimate judgment in patient care rests with the individual physician weighing the circumstances for an individual patient. Nevertheless, guidelines have become increasingly important because significant gaps between public health ...References1. Jencks SF, Cuerdon T, Burwen DR, Fleming B, Houck PM, Kussmaul AE, et al . Quality of medical care delivered to Medicare beneficiaries: a profile at state and national levels. JAMA. 2000;284:1670-6. [PMID: 11015797] CrossrefMedlineGoogle Scholar2. . Clinical reality of coronary prevention guidelines: a comparison of EUROASPIRE I and II in nine countries. EUROASPIRE I and II Group. 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[PMID: 10987629] MedlineGoogle Scholar5. Ryan TJ, Antman EM, Brooks NH, Califf RM, Hillis LD, Hiratzka LF, et al . 1999 update: ACC/AHA Guidelines for the Management of Patients with Acute Myocardial Infarction: Executive Summary and Recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). Circulation. 1999;100:1016-30. [PMID: 10468535] MedlineGoogle Scholar6. Williams SV, Fihn SD, Gibbons RJ. Guidelines for the management of patients with chronic stable angina: diagnosis and risk stratification. Ann Intern Med. 2001;135:530-47. LinkGoogle Scholar7. Beller GA. Coronary heart disease in the first 30 years of the 21st century: challenges and opportunities: The 33rd Annual James B. Herrick Lecture of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2001;103:2428-35. [PMID: 11369681] CrossrefMedlineGoogle Scholar8. Lee TH, Boucher CA. Clinical practice. Noninvasive tests in patients with stable coronary artery disease. N Engl J Med. 2001;344:1840-5. [PMID: 11407346] CrossrefMedlineGoogle Scholar9. Shaw LJ, Hachamovitch R, Berman DS, Marwick TH, Lauer MS, Heller GV, et al . The economic consequences of available diagnostic and prognostic strategies for the evaluation of stable angina patients: an observational assessment of the value of precatheterization ischemia. Economics of Noninvasive Diagnosis (END) Multicenter Study Group. J Am Coll Cardiol. 1999;33:661-9. [PMID: 10080466] MedlineGoogle Scholar10. . Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet. 1988;2:349-60. [PMID: 2899772] MedlineGoogle Scholar11. Newby LK, Ohman EM, Christenson RH, Moliterno DJ, Harrington RA, White HD, et al . Benefit of glycoprotein IIb/IIIa inhibition in patients with acute coronary syndromes and troponin t-positive status: the paragon-B troponin T substudy. Circulation. 2001;103:2891-6. [PMID: 11413076] CrossrefMedlineGoogle Scholar12. Sueta CA, Chowdhury M, Boccuzzi SJ, Smith SC, Alexander CM, Londhe A, et al . Analysis of the degree of undertreatment of hyperlipidemia and congestive heart failure secondary to coronary artery disease. Am J Cardiol. 1999;83:1303-7. [PMID: 10235085] CrossrefMedlineGoogle Scholar13. Costantini O, Huck K, Carlson MD, Boyd K, Buchter CM, Raiz P, et al . Impact of a guideline-based disease management team on outcomes of hospitalized patients with congestive heart failure. Arch Intern Med. 2001;161:177-82. [PMID: 11176730] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: E. Magnus Ohman, MD; Eric Peterson, MDAffiliations: Dr. Ohman: University of North Carolina at Chapel Hill; Chapel Hill, NC 27599-7075Dr. Peterson: Duke Clinical Research Institute; Durham, NC 27705Corresponding Author: E. Magnus Ohman, MD, Division of Cardiology, CB 7075, Burnett-Womack Building, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7075; e-mail, mohman@med.unc.edu.Current Author Addresses: Dr. Ohmar: Division of Cardiology, CB 7075, Burnett-Womack Building, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7075.Dr. Peterson: Duke Clinical Research Institute, 2400 Pratt Street, Seventh Floor, Durham, NC 27705. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoGuidelines for the Management of Patients with Chronic Stable Angina: Diagnosis and Risk Stratification Sankey V. Williams , Stephan D. Fihn , and Raymond J. Gibbons Metrics Cited byClinical evaluation and stress test have limited value in the diagnosis of in-stent restenosisThe REduction of Atherothrombosis for Continued Health (REACH) Registry: An international, prospective, observational investigation in subjects at risk for atherothrombotic events-study designChanging the model of care for patients with acute coronary syndromesEarly use of glycoprotein IIb/IIIa inhibitors in non–ST-elevation acute myocardial infarctionCardiology and emergency medicine: United We Stand, divided we fall 2 October 2001Volume 135, Issue 7Page: 527-529KeywordsACE inhibitorsAcute myocardial infarctionAnginaAspirinCardiovascular therapyClinical trialsHealth careHealth care qualityHeart failureMyocardial infarction ePublished: 2 October 2001 Issue Published: 2 October 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...