Abstract
The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD). Additionally, percutaneous coronary intervention may have a role in revascularization of patients with high burden of CAD. The primary objective of the appropriate use criteria is to improve physician decision making and patient education regarding expected benefits from revascularization and to guide future research.
| Original language | English |
|---|---|
| Pages (from-to) | 780-803 |
| Number of pages | 24 |
| Journal | The Journal of thoracic and cardiovascular surgery |
| Volume | 143 |
| Issue number | 4 |
| State | Published - Apr 1 2012 |
| Externally published | Yes |
Fingerprint
ASJC Scopus subject areas
- Medicine(all)
Cite this
ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update : a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear. / Coronary Revascularization Writing Group, Revascularization Writing Group; Patel, Manesh R.; Dehmer, Gregory J.; Hirshfeld, John W.; Smith, Peter K.; Spertus, John A.; Technical Panel, Panel; Masoudi, Frederick A.; Dehmer, Gregory J.; Patel, Manesh R.; Smith, Peter K.; Chambers, Charles E.; Ferguson, T. Bruce; Garcia, Mario J.; Grover, Frederick L.; Holmes, David R.; Klein, Lloyd W.; Limacher, Marian C.; Mack, Michael J.; Malenka, David J.; Park, Myung H.; Ragosta, Michael; Ritchie, James L.; Rose, Geoffrey A.; Rosenberg, Alan B.; Russo, Andrea M.; Shemin, Richard J.; Weintraub, William S.; Appropriate Use Criteria Task Force, Use Criteria Task Force; Hendel, Robert; Bailey, Steven R.; Douglas, Pamela S.; Hendel, Robert C.; Kramer, Christopher M.; Min, James K.; Patel, Manesh R.; Shaw, Leslee; Stainback, Raymond F.; Allen, Joseph M.; American College of Cardiology Foundation, College of Cardiology Foundation; American College of Cardiology Foundation Appropriate Use Criteria Task Force, College of Cardiology Foundation Appropriate Use Criteria Task Force; Society for Cardiovascular Angiography, for Cardiovascular Angiography; Society of Thoracic Surgeons, of Thoracic Surgeons; American Association of Thoracic Surgery, Association of Thoracic Surgery; American Heart Association, Heart Association; American Society of Nuclear Cardiology, Society of Nuclear Cardiology; Society of Cardiovascular Computed Tomography, of Cardiovascular Computed Tomography.
In: The Journal of thoracic and cardiovascular surgery, Vol. 143, No. 4, 01.04.2012, p. 780-803.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update
T2 - a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear
AU - Coronary Revascularization Writing Group, Revascularization Writing Group
AU - Patel, Manesh R.
AU - Dehmer, Gregory J.
AU - Hirshfeld, John W.
AU - Smith, Peter K.
AU - Spertus, John A.
AU - Technical Panel, Panel
AU - Masoudi, Frederick A.
AU - Dehmer, Gregory J.
AU - Patel, Manesh R.
AU - Smith, Peter K.
AU - Chambers, Charles E.
AU - Ferguson, T. Bruce
AU - Garcia, Mario J.
AU - Grover, Frederick L.
AU - Holmes, David R.
AU - Klein, Lloyd W.
AU - Limacher, Marian C.
AU - Mack, Michael J.
AU - Malenka, David J.
AU - Park, Myung H.
AU - Ragosta, Michael
AU - Ritchie, James L.
AU - Rose, Geoffrey A.
AU - Rosenberg, Alan B.
AU - Russo, Andrea M.
AU - Shemin, Richard J.
AU - Weintraub, William S.
AU - Appropriate Use Criteria Task Force, Use Criteria Task Force
AU - Hendel, Robert
AU - Bailey, Steven R.
AU - Douglas, Pamela S.
AU - Hendel, Robert C.
AU - Kramer, Christopher M.
AU - Min, James K.
AU - Patel, Manesh R.
AU - Shaw, Leslee
AU - Stainback, Raymond F.
AU - Allen, Joseph M.
AU - American College of Cardiology Foundation, College of Cardiology Foundation
AU - American College of Cardiology Foundation Appropriate Use Criteria Task Force, College of Cardiology Foundation Appropriate Use Criteria Task Force
AU - Society for Cardiovascular Angiography, for Cardiovascular Angiography
AU - Society of Thoracic Surgeons, of Thoracic Surgeons
AU - American Association of Thoracic Surgery, Association of Thoracic Surgery
AU - American Heart Association, Heart Association
AU - American Society of Nuclear Cardiology, Society of Nuclear Cardiology
AU - Society of Cardiovascular Computed Tomography, of Cardiovascular Computed Tomography
PY - 2012/4/1
Y1 - 2012/4/1
N2 - The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD). Additionally, percutaneous coronary intervention may have a role in revascularization of patients with high burden of CAD. The primary objective of the appropriate use criteria is to improve physician decision making and patient education regarding expected benefits from revascularization and to guide future research.
AB - The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD). Additionally, percutaneous coronary intervention may have a role in revascularization of patients with high burden of CAD. The primary objective of the appropriate use criteria is to improve physician decision making and patient education regarding expected benefits from revascularization and to guide future research.
UR - http://www.scopus.com/inward/record.url?scp=84873022321&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873022321&partnerID=8YFLogxK
M3 - Article
C2 - 22424518
AN - SCOPUS:84873022321
VL - 143
SP - 780
EP - 803
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 4
ER -