New Guidelines Simplify Care for Acute Coronary Syndrome

Alphabetized rules based on results of recent clinical trials

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WEDNESDAY, Jan. 19, 2005 (HealthDayNews) -- New, simplified "alphabet" guidelines for doctors managing patients with acute coronary syndrome are outlined in a study in the Jan. 19 issue of the Journal of the American Medical Association.

This alphabet approach was developed by researchers at Johns Hopkins Medical Institutions. They reviewed medical literature from 1990 to 2004 to identify the most effective and safe management practices for people with acute coronary syndrome (chest pain at rest or with mild exertion).

The new guidelines are based on results from recent clinical trials and on guidelines developed by the American Heart Association and the American College of Cardiology.

The Hopkins team concluded that once doctors identify patients most likely to benefit from either an early conservative or early invasive strategy, a simple 'ABCDE' approach can be used in a comprehensive management plan.

This approach includes:

  • "A" for antiplatelet therapy, anticoagulation, angiotensin converting enzyme inhibition, and angiotensin receptor blockade
  • "B" for beta-blockade and blood pressure control
  • "C" for cholesterol treatment and cigarette smoking cessation
  • "D" for diabetes management and diet
  • "E" for exercise.

"Many doctors think existing guidelines are lengthy and complex, and therefore difficult to implement in the clinic and at home by patients," study senior investigator Dr. Roger S. Blumenthal, director of the Ciccarone Preventive Cardiology Center at Hopkins, said in a prepared statement.

An estimated 1.6 million Americans suffer from acute coronary syndrome each year, but less than half get optimal treatment due to the complexity of implementing and monitoring drug treatments and lifestyle changes, Blumenthal said.

More information

The American Heart Association has more about acute coronary syndrome.

SOURCE: Johns Hopkins Medical Institutions, news release, Jan. 18, 2005

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