title: Updating an institutional chest pain algorithm: incorporating new evidence on emerging pharmacotherapy.
abstract: Clinical treatment pathways are useful to ensure that evidence-based medicine is consistently applied in hospital systems and have been shown to improve patient outcomes. Such pathways need to be regularly updated and revised by incorporating new evidence from clinical trials to ensure optimal clinical care. In 2011, we published the Columbia University Medical Center/New York Presbyterian Hospital - Clinical Pathways for Acute Coronary Syndromes and Chest Pain. This algorithm includes primary percutaneous coronary intervention for all patients with ST-segment elevation myocardial infarction and an early invasive approach for patients with non-ST-segment elevation myocardial infarction. Since our last chest pain algorithm update, the novel antiplatelet agent ticagrelor has been introduced in the United States, resulting in an important revision of our acute coronary syndrome clinical pathways. Herein, we present our updated chest pain algorithm and provide rationale for the changes that we have made to our protocol.
authors: Department of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, NY, USA.
authors: Gregg F
authors: GF
authors: Rosner
authors: Gregg W
authors: GW
authors: Stone
authors: Jennifer
authors: J
authors: Stant
authors: Jennifer
authors: J
authors: Burr
authors: Amelia
authors: A
authors: Tirado
authors: Michael
authors: M
authors: Collins
authors: Jeffrey
authors: J
authors: Moses
authors: Martin B
authors: MB
authors: Leon
authors: James
authors: J
authors: Giglio
authors: LeRoy E
authors: LE
authors: Rabbani
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000628:therapy*; D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use*; D002637:Chest Pain / Q000209:etiology / Q000628:therapy*; D019091:Critical Pathways / Q000592:standards; D004562:Electrocardiography; D055416:Evidence-Based Emergency Medicine; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors