|Articles|November 1, 2004

New Guidelines for the Management of Patients with MI

Statistics indicate that in 2001 there were ~1.7 millionhospital discharges for acute coronary syndromes(ACS). According to the National Registry ofMyocardial Infarction 4, it is estimated that ~30% of theACS patients have ST-elevation myocardial infarction(STEMI). This percentage translates to ~500,000 STEMIevents per year in the United States.1,2

New Guidelines

Recently, the American Heart Association (AHA), in partnershipwith the American College of Cardiology (ACC),published a new set of guidelines for the management ofpatients with STEMI.3 The focus of this article is on medicationsused in the management of STEMI patients.

For ease of comparison, a Table is provided that reviewsand compares only the changes between the old (1999) andthe new (2004) guidelines. Readers are encouraged to referto the actual guidelines for a comprehensive review of eachsection.

Recommendation Classifications and Levels ofEvidence

The customary ACC/AHA classifications (I, 7 IIa, IIb, andIII) and levels of evidence (A, B, and C) are used in theseguidelines:

  • Class I: Conditions for which there is evidence or generalagreement that a given procedure or treatment is usefuland effective
  • Class II: Conditions for which there is conflicting evidenceor a divergence of opinion about the usefulness/efficacyof a procedure or treatment
  • Class IIa: Weight of evidence/opinion in favor of usefulness/efficacy
  • Class IIb: Usefulness/efficacy less well established byevidence/opinion
  • Class III: Conditions for which there is evidenceand/or general agreement that the procedure/treatment isnot useful/effective and in some cases may be harmful
  • Level of Evidence A: Data derived from multiple populationrisk strata
  • Level of Evidence B: Data derived from limited populationrisk strata
  • Level of Evidence C: Data derived from very limitedrisk strata

For a list of references, send a stamped, self-addressed envelope to:References Department, Attn. A. Stahl, Pharmacy Times,241 Forsgate Drive, Jamesburg, NJ 08831;or send an e-mail request to: astahl@mwc.com.

Dr. Ng is an instructor of pharmacy practice and a cardiologypharmacy practice resident, Midwestern University, College ofPharmacy-Glendale. Dr. Nguyen is a pharmacist with BannerThunderbird Medical Center. Dr. Tafreshi is an associate professorof pharmacy and medicine and director of the cardiologypharmacy practice residency, Midwestern University,College of Pharmacy-Glendale.

Articles in this issue

almost 21 years ago

Article

Geriatric Pharmacology

almost 21 years ago

Article

Management of Bacterial Rhinosinusitis

almost 21 years ago

Article

Early RA Treatment Proves Beneficial

almost 21 years ago

Article

Topical Creams Work Temporarily

almost 21 years ago

Article

Mental Anguish Is Common with Arthritis

almost 21 years ago

Article

Scanner Detects Hand Arthritis

almost 21 years ago

Article

OA: All in the Family

Newsletter

Stay informed on drug updates, treatment guidelines, and pharmacy practice trends—subscribe to Pharmacy Times for weekly clinical insights.

Latest CME