Professional Statements and Societal Positions Guidelines
American College of Cardiology Foundation and American Heart Association (ACCF/AHA)-2019
In conjunction with the implementation of the modular knowledge chunk, standardized guideline formats and a target maximum number of words have been implemented. The intentions of this format are: 1) to make a guideline more recommendation-centric; and 2) to limit text (and thus the overall size of the guideline), making the guideline more relevant and readable for the busy practitioner. Detailed and extensive background information, which can readily be found in book chapters, on websites, or via search engines, is deemphasized. Rather, the focus of the guideline is on the recommendations themselves, presented in the modular knowledge chunk format.
So as to decrease the total text (and length) of guidelines, for each aspect of the guideline and each section of the modular chunk, maximum word targets (goals) have been established. Text at the beginning of each major section of the guideline that presents recommendations, the synopsis text for each modular chunk, and recommendation-specific supplemental text all have a target maximum number of 200 words.
The goal for Section 1 of the guideline (methodology, organization of the writing committee, document review and approval, abbreviations and acronyms) and section 2 (general concepts, brief background information, overarching principles) is a maximum of 2,000 words and 5 journal-formatted pages for each section. This standardized guideline format is a process-in-evolution that will bring a more standardized layout, and more limited text, to guidelines, although it will still allow guideline writing committee chairs some discretion in how to best construct each specific guideline. The current iteration of this standardized guideline.
American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines / Society for Cardiovascular Angiography and Interventions (ACCF/AHA/SCAI)-2018
The purpose of the 2018 ACC/AHA Blood Cholesterol guideline is to address the practical management of individuals with high blood cholesterol and related disorders. Since the 2013 ACC/AHA cholesterol guideline, newer cholesterol-lowering agents (non-statin drugs) have been introduced and subjected to randomized controlled trials, including ezetimibe and PCSK9 inhibitors. Most individuals with Atherosclerotic Cardiovascular Disease are treated with statins alone. This guideline pays consistent attention to a clinician–individual risk discussion for making shared decisions. This clinician–individual risk discussion can include other risk-enhancing factors, and when risk status is uncertain, a coronary artery calcium score is an option to facilitate decision-making in adults ≥40 years of age
Guideline on the Management of Blood Cholesterol AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA-2019
The ACCF/AHA/ACP/AATS/PCNA/SACAI/STS released a guideline for the diagnosis and management of individuals with stable ischemic heart disease in 2012. Specific DES types were not mentioned, although they did recommend that individuals who are unlikely to tolerate or comply with DAPT for an appropriate duration should not receive PCI with coronary stenting using either BMS or DES.
European Society of Cardiology (ESC)-1996
The ESC originally developed guidelines for management of acute myocardial infarction (AMI) in individuals with ST-segment elevation in 1996. These guidelines were revised in 2012, and state the following:
Stenting is recommended over balloon angioplasty for primary PCI.
- DES should be used instead of BMS for individuals who are able to tolerate and comply with DAPT.
In addition, the guidelines note concerns regarding the increased risk of very late stent thrombosis and reinfarction with DES versus BMS.