RPHTn/526x297-m0K.jpg' alt='A History Of The Future Donna Goodman Pdf Manual' title='A History Of The Future Donna Goodman Pdf Manual' />Associated Press News. A History Of The Future Donna Goodman Pdf Files' title='A History Of The Future Donna Goodman Pdf Files' />2013 ACCFAHA Guideline for the Management of STElevation Myocardial Infarction Executive Summary A Report of the American College of Cardiology FoundationAmerican. Performance as Research Method Read Pearson, Mike, and Michael Shanks. Theatrearchaeology. LondonNew York Routledge. ACCFAHA Guideline for the Management of ST Elevation Myocardial Infarction Executive Summary. Table of Contents. Preamble. 53. 01. Introduction. 53. Methodology and Evidence Review. Organization of the Writing Committee. Document Review and Approval. Onset of Myocardial Infarction Recommendations. Regional Systems of STEMI Care, Reperfusion Therapy, and Time to Treatment Goals. Evaluation and Management of Patients With STEMI and Out of Hospital Cardiac Arrest. Reperfusion at a PCI Capable Hospital Recommendations. Primary PCI in STEMI5. Aspiration Thrombectomy. Use of Stents in Patients With STEMI5. Antiplatelet Therapy to Support Primary PCI for STEMI5. Anticoagulant Therapy to Support Primary PCI5. Reperfusion at a NonPCI Capable Hospital Recommendations. Fibrinolytic Therapy When There Is an Anticipated Delay to Performing Primary PCI Within 1. Minutes of FMC5. 37. Adjunctive Antithrombotic Therapy With Fibrinolysis. Adjunctive Antiplatelet Therapy With Fibrinolysis. Adjunctive Anticoagulant Therapy With Fibrinolysis. Transfer to a PCI Capable Hospital After Fibrinolytic Therapy. Transfer of Patients With STEMI to a PCI Capable Hospital for Coronary Angiography After Fibrinolytic Therapy. Delayed Invasive Management Recommendations. Coronary Angiography in Patients Who Initially Were Managed With Fibrinolytic Therapy or Who Did Not Receive Reperfusion. PCI of an Infarct Artery in Patients Who Initially Were Managed With Fibrinolysis or Who Did Not Receive Reperfusion Therapy. PCI of a Noninfarct Artery Before Hospital Discharge. Adjunctive Antithrombotic Therapy to Support Delayed PCI After Fibrinolytic Therapy. Antiplatelet Therapy to Support PCI After Fibrinolytic Therapy. Anticoagulant Therapy to Support PCI After Fibrinolytic Therapy. Coronary Artery Bypass Graft Surgery Recommendations. CABG in Patients With STEMI5. Timing of Urgent CABG in Patients With STEMI in Relation to Use of Antiplatelet Agents. Routine Medical Therapies Recommendations. Beta Blockers. 54. Renin Angiotensin Aldosterone System Inhibitors. Lipid Management. Complications After STEMI Recommendations. Treatment of Cardiogenic Shock. Implantable Cardioverter Defibrillator Therapy Before Discharge. Pacing in STEMI5. Management of Pericarditis After STEMI5. Anticoagulation. 54. Risk Assessment After STEMI Recommendations. Flip Text Software. Use of Noninvasive Testing for Ischemia Before Discharge. Assessment of LV Function. Assessment of Risk for Sudden Cardiac Death. Posthospitalization Plan of Care Recommendations. References. 54. 4Appendix 1. Author Relationships With Industry and Other Entities Relevant5. Appendix 2. Reviewer Relationships With Industry and Other Entities Relevant5. Preamble. The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease. When properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can improve the quality of care, optimize patient outcomes, and favorably affect costs by focusing resources on the most effective strategies. An organized and directed approach to a thorough review of evidence has resulted in the production of clinical practice guidelines that assist physicians in selecting the best management strategy for an individual patient. Moreover, clinical practice guidelines can provide a foundation for other applications, such as performance measures, appropriate use criteria, and both quality improvement and clinical decision support tools. The American College of Cardiology Foundation ACCF and the American Heart Association AHA have jointly produced guidelines in the area of cardiovascular disease since 1. The ACCFAHA Task Force on Practice Guidelines Task Force, charged with developing, updating, and revising practice guidelines for cardiovascular diseases and procedures, directs and oversees this effort. Writing committees are charged with regularly reviewing and evaluating all available evidence to develop balanced, patient centric recommendations for clinical practice. Experts in the subject under consideration are selected by the ACCF and AHA to examine subject specific data and write guidelines in partnership with representatives from other medical organizations and specialty groups. Writing committees are asked to perform a literature review weigh the strength of evidence for or against particular tests, treatments, or procedures and include estimates of expected outcomes where such data exist. Patient specific modifiers, comorbidities, and issues of patient preference that may influence the choice of tests or therapies are considered. When available, information from studies on cost is considered, but data on efficacy and outcomes constitute the primary basis for the recommendations contained herein. In analyzing the data and developing recommendations and supporting text, the writing committee uses evidence based methodologies developed by the Task Force. The Class of Recommendation COR is an estimate of the size of the treatment effect considering risks versus benefits in addition to evidence andor agreement that a given treatment or procedure is or is not usefuleffective or in some situations may cause harm. The Level of Evidence LOE is an estimate of the certainty or precision of the treatment effect. The writing committee reviews and ranks evidence supporting each recommendation with the weight of evidence ranked as LOE A, B, or C according to specific definitions that are included in Table 1. Studies are identified as observational, retrospective, prospective, or randomized where appropriate. For certain conditions for which inadequate data are available, recommendations are based on expert consensus and clinical experience and are ranked as LOE C. When recommendations at LOE C are supported by historical clinical data, appropriate references including clinical reviews are cited if available. Hex Socket Head Set Screw Dimensions on this page. For issues for which sparse data are available, a survey of current practice among the clinician members of the writing committee is the basis for LOE C recommendations and no references are cited. The schema for COR and LOE is summarized in Table 1, which also provides suggested phrases for writing recommendations within each COR. Table 1. Applying Classification of Recommendation and Level of Evidence. Appendix 1. Author Relationships With Industry and Other Entities Relevant2. ACCFAHA Guideline for the Management of ST Elevation Myocardial Infarction. A new addition to this methodology is separation of the Class III recommendations to delineate whether the recommendation is determined to be of no benefit or is associated with harm to the patient. In addition, in view of the increasing number of comparative effectiveness studies, comparator verbs and suggested phrases for writing recommendations for the comparative effectiveness of one treatment or strategy versus another are included for COR I and IIa, LOE A or B only. In view of the advances in medical therapy across the spectrum of cardiovascular diseases, the Task Force has designated the term guideline directed medical therapy GDMT to represent optimal medical therapy as defined by ACCFAHA guideline recommended therapies primarily Class I. This new term, GDMT, will be used throughout subsequent guidelines.