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

Revascularization Writing Group Coronary Revascularization Writing Group, Manesh R. Patel, Gregory J. Dehmer, John W. Hirshfeld, Peter K. Smith, John A. Spertus, Panel Technical Panel, Frederick A. Masoudi, Gregory J. Dehmer, Manesh R. Patel, Peter K. Smith, Mario J. Garcia, T. Bruce Ferguson, Mario J. Garcia, Frederick L. Grover, David R. Holmes, Lloyd W. Klein, Marian C. Limacher, Michael J. Mack, David J. Malenka & 27 others Myung H. Park, Michael Ragosta, James L. Ritchie, Geoffrey A. Rose, Alan B. Rosenberg, Andrea M. Russo, Richard J. Shemin, William S. Weintraub, Use Criteria Task Force Appropriate Use Criteria Task Force, Michael J. Wolk, Steven R. Bailey, Pamela S. Douglas, Robert C. Hendel, Christopher M. Kramer, James K. Min, Manesh R. Patel, Leslee Shaw, Raymond F. Stainback, Joseph M. Allen, College of Cardiology Foundation American College of Cardiology Foundation, College of Cardiology Foundation Appropriate Use Criteria Task Force American College of Cardiology Foundation Appropriate Use Criteria Task Force, for Cardiovascular Angiography Society for Cardiovascular Angiography, of Thoracic Surgeons Society of Thoracic Surgeons, Association of Thoracic Surgery American Association of Thoracic Surgery, Heart Association American Heart Association, Society of Nuclear Cardiology American Society of Nuclear Cardiology, of Cardiovascular Computed Tomography Society of Cardiovascular Computed Tomography

Research output: Contribution to journalArticle

54 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)780-803
Number of pages24
JournalJournal of Thoracic and Cardiovascular Surgery
Volume143
Issue number4
StatePublished - Apr 2012
Externally publishedYes

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Advisory Committees
Cardiology
Survival
Coronary Artery Disease
Health
Patient Education
Percutaneous Coronary Intervention
Acute Coronary Syndrome
Coronary Artery Bypass
Anatomy
Decision Making
Ischemia
Physicians
Therapeutics

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.; Garcia, Mario J.; 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; Wolk, Michael J.; 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: Journal of Thoracic and Cardiovascular Surgery, Vol. 143, No. 4, 04.2012, p. 780-803.

Research output: Contribution to journalArticle

Coronary Revascularization Writing Group, RWG, Patel, MR, Dehmer, GJ, Hirshfeld, JW, Smith, PK, Spertus, JA, Technical Panel, P, Masoudi, FA, Dehmer, GJ, Patel, MR, Smith, PK, Garcia, MJ, Ferguson, TB, Garcia, MJ, Grover, FL, Holmes, DR, Klein, LW, Limacher, MC, Mack, MJ, Malenka, DJ, Park, MH, Ragosta, M, Ritchie, JL, Rose, GA, Rosenberg, AB, Russo, AM, Shemin, RJ, Weintraub, WS, Appropriate Use Criteria Task Force, UCTF, Wolk, MJ, Bailey, SR, Douglas, PS, Hendel, RC, Kramer, CM, Min, JK, Patel, MR, Shaw, L, Stainback, RF, Allen, JM, American College of Cardiology Foundation, COCF, American College of Cardiology Foundation Appropriate Use Criteria Task Force, COCFAUCTF, Society for Cardiovascular Angiography, FCA, Society of Thoracic Surgeons, OTS, American Association of Thoracic Surgery, AOTS, American Heart Association, HA, American Society of Nuclear Cardiology, SONC & Society of Cardiovascular Computed Tomography, OCCT 2012, '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', Journal of Thoracic and Cardiovascular Surgery, vol. 143, no. 4, pp. 780-803.
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. ; Garcia, Mario J. ; 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 ; Wolk, Michael J. ; 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. / 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. In: Journal of Thoracic and Cardiovascular Surgery. 2012 ; Vol. 143, No. 4. pp. 780-803.
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title = "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",
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.",
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AU - Malenka, David J.

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AU - Ragosta, Michael

AU - Ritchie, James L.

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AU - Weintraub, William S.

AU - Appropriate Use Criteria Task Force, Use Criteria Task Force

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AU - Society for Cardiovascular Angiography, for Cardiovascular Angiography

AU - Society of Thoracic Surgeons, of Thoracic Surgeons

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