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EvidenceMedicine.com / GuidelineMedicine.com

CARDIOLOGY Guidelines and Reviews

ACC Guidelines A-Z

AHA Guidelines A-Z

National Heart Lung and Blood Instit/NIH  (Includes JNC 7-HTN, NCEP/ATP 3-Cholesterol)

ACC/AHA JULY 21, 2004 ST-ELEVATION MYOCARDIAL INFARCTION GUIDELINES
 - SUMMARY http://www.americanheart.org/presenter.jhtml?identifier=3023107

CHOLESTEROL GUIDELINES (UPDATE OF NECEP/ATP 3 2001) RELEASED JULY 12, 2004 IN CIRCULATION: NEW GOAL of LDL<70 in highest risk patients.
abstract:  http://circ.ahajournals.org/cgi/content/abstract/110/2/227

Acute Coronary Syndromes: 

  ACC/AHA 2002 USA and NSTEMI Summary

Acute Myocardial Infarction (ST-Elevation)- also see Acute Coronary Syndromes above:

  ACC/AHA 20004 ST-Elevation MI Summary:  
    http://www.americanheart.org/presenter.jhtml?identifier=3023107   

  ACC/AHA Acute MI 2001 Summary: (NOTE THIS HAS BEEN REPLACED BY 2004 Guideliines - above)
    http://qc.acc.org/clinical/guidelines/stemi/exec_summ/index.pdf 

Atrial Fibrillation: 

  ACC/AHA/ESC A Fib 2001 Summary

  ICSI A Fib 2003

Endocarditis

  AHA Prevention Endocarditis 1997

  DIRECT LINK TABLE ANTBX REGIMEN ORAL/ESOPH PROCEDURES: http://www.circ.ahajournals.org/cgi/content/full/96/1/358/T4

  DIRECT LINK TABLE ANTBX REGIMEN GI/GU PROCEDURES: http://www.circ.ahajournals.org/cgi/content/full/96/1/358/T5  

  AHA Dx and Management Endocarditis 1998

Heart Failure: 

  ACC/AHA Heart Failure 2001 Summary

Hypertrophic Cardiomyopathy: 

  ACC/ESC HCM 2003

  NEJM Review HCM: March 13, 1997 vol 336 p775-85

  NEJM Clinical Practice HCM: March 25, 2004 vol 350 p1320

Omega 3 Fish Oils

  AHA Online statement referring to Nov 2002 Circulation recommendations:
    http://www.americanheart.org/presenter.jhtml?identifier=3006581

   2002 AHA Statement: http://circ.ahajournals.org/cgi/content/full/106/21/2747     

Pacemakers and Defibrillators: 

  ACC/AHA/NASPE Pacers 2002 Summary PDF

  NEJM Review ICDs: Nov 6, 2003 vol 349 p1836-47

Pre-op Evaluation for Non-Cardiac Surgery

  ACC/AHA Periop Noncardiac Surgery Summary

  DIRECT LINK: ALGORITHM PREOP 2002 (ONE PAGE FLOW DIAGRAM - PRINT PDF)

Syncope

  NEJM Review Syncope: Dec. 21, 2000 vol 343 p1856-62

Valvular Heart Disease:

  ACC/AHA Valvular Dis 2000 Pocket Guidelines PDF

_________________________________________________________________________________________________

INFECTIOUS DISEASES

IDSA Guidelines: http://www.idsociety.org/Template.cfm?Section=Practice_Guidelines&Template=/Content/NavigationMenu/Practice_Guidelines 

Community Acquired Pneumonia 2003 Update: http://www.journals.uchicago.edu/CID/journal/issues/v37n11/32441/32441.html 

IDSA/ATS/CDC Tuberculosis 2003: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm 
ATS/IDSA 2005:“GUIDELINES FOR THE MANAGEMENT OF ADULTS WITH HOSPITAL-ACQUIRED, VENTILATOR-ASSOCIATED, AND HEALTHCARE-ASSOCI ATED PNEUMONIA”
http://www.thoracic.org/adobe/statements/guide1-29.pdf 

_________________________________________________________________________________________________

DIABETES / ENDOCRINOLOGY

AACE Guidelines: http://www.aace.com/clin/guidelines/ 

ADA for Professionals http://www.diabetes.org/for-health-professionals-and-scientists/professionals.jsp  

DIABETES

2004 ADA Diabetes Guidelines: http://care.diabetesjournals.org/content/vol27/suppl_1/ 
ADA 2005 CLINICAL PRACTICE GUIDELINES FOR DIABETES
http://care.diabetesjournals.org/content/vol28/suppl_1/#INTRODUCTION

2006 ADA DIABETES PRACTICE GUIDELINES:
http://care.diabetesjournals.org/cgi/content/full/29/suppl_1/s4?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=standards+of+medical+care&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT  

_________________________________________________________________________________________________  

PULMONARY / THORACIC

American Thoracic Society Guidelines: http://www.thoracic.org/statements/ 

NEW ACCP (American College of Chest Physicians) July 2004 Guidelines and Diagnosis and Management of Pulmonary Arterial Hypertension released in journal CHEST (supplement) www.chestjournal.org/content/vol126/1_suppl/

^{ATS/IDSA 2005:“GUIDELINES FOR THE MANAGEMENT OF ADULTS WITH HOSPITAL-ACQUIRED, VENTILATOR-ASSOCIATED, AND HEALTHCARE-ASSOCIATED PNEUMONIA”}
http://www.thoracic.org/adobe/statements/guide1-29.pdf

_________________________________________________________________________________________________

GASTROENTEROLOGY

American College of Gastroenterology Guidelines: http://www.acg.gi.org/physicianforum/guides/index.html

NIH/NIDDC/NDDIK A-Z Digestive Diseases: http://digestive.niddk.nih.gov/ddiseases/a-z.asp    

HEPATITIS

NIDDK (NIH)Chronic Hepatitis C Management 2003: http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/index.htm 

NIH Management of Hepatitis C 2002: http://consensus.nih.gov/cons/116/116cdc_intro.htm 

HEMOCHROMATOSIS INFO PAGE: http://digestive.niddk.nih.gov/ddiseases/pubs/hemochromatosis/index.htm 

_________________________________________________________________________________________________

NEPHROLOGY

NIDDK/NIH Kidney and Urologic Diseases A-Z http://kidney.niddk.nih.gov/kudiseases/a-z.asp

JNC 7 Hypertension Guidelines: http://www.nhlbi.nih.gov/guidelines/hypertension/index.htm  

(1) MONDAY’S QUIZ QUESTION:

ACCORDING TO THE NCEP/ATP 3 (2001) AND THE JULY 2004 UPDATE WHICH ARE TRUE?

A) “In high-risk persons, the recommended LDL-C is <100 mg/dL . . . <70 mg/dL is a therapeutic option  . . .
     especially for patients at very high risk”
B) “For moderately-high risk persons (2+ risk factors and 10-year risk of 10 to 20%), the recommended goal is
     <130 mg/dL . . . <100 mg/dL is a therapeutic option . . .”
C) “Moderate risk: 2+ risk factors (10 year risk <10%)”  LDL Goal: “ < 130 mg/dL”)
D) “Lower risk: 0-1 risk factors” LDL Goal: “<160 mg/dL)
E) All of above correct
F) Only A & B correct
G) None of above correct

HINT: for answers go to GUIDELINES PAGE for link to the relevant guideline.

TUESDAY’S QUESTIONS:

ACCORDING TO NECEP/ATP 3 AND 20004 UPDATE:

(2) WHEN USING STATIN THERAPY, A “30% - 40% REDUCTION OF LDL-C” IS A GOAL.  WHICH ARE CORRECT LIKELY DOSES REQUIRED TO OBTAIN THIS REDUCTION BASED ON CURRENT DATA?

A) ATORVASTATIN (LIPITOR)        10 MG
B) LOVASTATIN (MEVACOR)        40 MG
C) PRAVASTATIN (PRAVACHOL) 40 MG
D) SIMVISTATIN (ZOCOR)             20-40 MG
E) FLUVASTATIN                         40-80 MG
F) ROSUVASTATIN (CRESTOR)  5-10 MG
G) A-E ARE CORRECT
H) ALL ARE CORRECT”
I) NONE ARE CORRECT

HINT: ACCESS GUIDELINES FROM MEDICAL GUIDELINES PAGE (OR ON HOME PAGE BELOW) GO TO TABLE 1 ON PAGE 233 OF PDF DOCUMENT.  SOME ANSWERS WILL BE GIVEN DIRECTLY ON MEDICAL GUIDELINES AND MEDICAL SEARCHES PAGES THROUGHOUT THE WEEK.

(note: if all were correct, that would be about 10 mg for lipitor, crestor and about 40 mg for others)

DO YOU KNOW THE BRAND NAME FOR FLUVASTATIN?  IF NOT GO TO DRUG INFO PAGE - CLICK MEDLINE PLUS DRUG INFO AND SEARCH.

WEDNESDAY’S QUESTION:
(3) ACCORDING TO NCEP/ATP 3 2001/2004 THE “HIGH RISK” CATEGORY CONSISTS OF “CHD OR CHD RISK EQUIVALENTS.”  WHICH QUALIFY?

A) “MYOCARDIAL INFARCTION, UNSTABLE ANGINA, CORONARY ARTERY PROCEDURES . . . OR . . .  CLINICALLY SIGNIFICANT ISCHEMIA”
B) “PERIPHERAL ARTERIAL DISEASE”
C) “ ABDOMINAL AORTIC ANEURYSM”
D) “CAROTID ARTERY DISEASE”  (WITH TIA, CVA OR >50%)
E) “DIABETES”
F) “2+ RISK FACTORS WITH 10-YEAR RISK FOR HARD CHD >20%”
G) ALL OF ABOVE
H) A, B AND E ONLY
I) NONE OF ABOVE

THURSDAY’S QUESTION”
(4) ACCORDING TO NCEP/ATP 3 2001/2004, WHICH COUNT AS “RISK FACTORS”
A) “CIGARETTE SMOKING”
B) “HYPERTENSION”
C) “LOW HDL CHOLESTEROL (<40 MG/DL)
D) “FAMILY HISTORY OF PREMATURE CHD”
E) “DIABETES”
F) A-D ONLY, DIABETES SHOULD BE BE CONSIDERED A CHD EQUIVALENT NOT JUST A RISK FACTOR FOR  NCEP/ATP PURPOSES
G) A-E

 

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