ACC Releases New Criteria for Coronary Revascularization in Patients with ACS

The American College of Cardiology, in conjunction with The American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society of Thoracic Surgeons, has published appropriate use criteria for coronary revascularization in patients with acute coronary syndrome (ACS).

“To address the expanding clinical indications for coronary revascularization, and in an effort to align the subject matter with the most current American College of Cardiology/American Heart Association guidelines, the new appropriate use criteria for coronary artery revascularization were separated into 2 documents addressing ACS and stable ischemic heart disease individually.”
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The panel created 17 clinical scenarios mimicking patient presentation and reassesses clinical scenarios that may have been affected by significant changes in medical literature that occurred since the last document was published. These scenarios were scored by a separate rating panel and categorized as patients for which revascularization was appropriate, rarely appropriate, or may be appropriate.

In scenarios involving ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction, as well as unstable angina and intermediate- or high-risk features revascularization was considered appropriate.

“As in prior versions of the [appropriate use criteria], these revascularization ratings should be used to reinforce existing management strategies and identify patient populations that need more information to identify the most effective treatments,” the panel concluded.

—Michael Potts

Reference:

Patel MR, Calhoon JH, Dehmer GJ, et al. Coronary Revascularization Writing Group. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 appropriate use criteria for coronary revascularization in patients with acute coronary syndromes [published online December 22, 2016]. JACC. doi:10.1016/j.jacc.2016.10.034.