2004 American College of Cardiology/American Heart Association Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: Implications for Emergency Department Practice
Received 2 September 2004; received in revised form 15 October 2004; accepted 1 November 2004. published online 15 February 2005.
The American College of Cardiology and the American Heart Association last published evidence-based guidelines for the management of ST-segment elevation myocardial infarction (STEMI) in 1999. In mid-2004, in recognition of the evolution and improvement of many of the most basic tenets of clinical management of STEMI since that time, an updated edition of the STEMI guidelines has been published. These guidelines offer many evidence-based recommendations that are pertinent to the out-of-hospital and emergency department care of STEMI patients, including initial evaluation, risk stratification, stabilizing management, and the choice between pharmacologic and mechanical revascularization. These are presented and discussed here.
From the Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA (Pollack); University of California at Davis, Sacramento, CA (Diercks); and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (Roe, Peterson)
Address for correspondence: Charles V. Pollack, Jr., MD, MA, Department of Emergency Medicine, Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107; fax 610-687-0137
Funding and support: All authors have received honoraria or research support (direct or indirect) from Aventis Pharmaceuticals, Millennium Pharmaceuticals, Schering-Plough, Bristol-Myers-Squibb, and Sanofi, which market therapeutic agents cited in this article. Dr. Pollack has received honoraria from Genentech.
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