The "Acute coronary syndromes: consensus recommendations for translating knowledge into action" position statement is based on a false premise.

Abstract

Recent National Heart Foundation of Australia (NHFA) guidelines for management of acute coronary syndromes (ACS) recommend increasing the rates of early invasive management of ACS and providing equal access for all Australians to percutaneous coronary intervention (PCI) facilities. For patients with ACS managed in regional hospitals without PCI facilities, review of the evidence does not show unequivocal benefit of early routine PCI over selective PCI for patients with non-ST-segment-elevation ACS or ST-elevation myocardial infarction. The current pattern of transfer based on the NHFA guidelines is expensive and disruptive of patient care, as well as undermining regional health care services. Further increase in transfer rates and increases in PCI facilities would divert resources away from supporting the regional infrastructure needed to provide evidence-based therapies, without any evidence that lives would be saved.

• Authors: Brett H Forge
• Journal: The Medical journal of Australia (Med J Aust) Vol. 192 Issue 12 Pg. 696-9 (Jun 21 2010) ISSN: 0025-729X [Print] Australia
• PMID: 20565348 (Publication Type: Journal Article)

Chemical References

• Fibrinolytic Agents
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Platelet Aggregation Inhibitors

Topics

• Acute Coronary Syndrome (drug therapy, surgery)
• Angina, Unstable (drug therapy, surgery)
• Cardiac Catheterization (standards)
• Electrocardiography
• Evidence-Based Medicine (standards)
• Fibrinolytic Agents (therapeutic use)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Myocardial Infarction (drug therapy, surgery)
• Platelet Aggregation Inhibitors (therapeutic use)
• Practice Guidelines as Topic (standards)
• Referral and Consultation (standards)
• Risk