title: Comparison of the American College of Cardiology/American Heart Association and the European Society of Cardiology guidelines for the management of patients with non-ST-segment elevation acute coronary syndromes.
abstract: BACKGROUND
  The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) have been developing guidelines to assist clinicians in making evidence-based decisions.
  
  
  METHODS
  The current ACC/AHA and ESC guidelines for non-ST-segment elevation acute coronary syndromes (NSTE-ACS) that were updated in 2014 and 2015, respectively, were compared to assess the number of recommendations on the basis of class of recommendation and level of evidence (LOE), the sources cited, and the content.
  
  
  RESULTS
  The total number of recommendations in the ACC/AHA and ESC guidelines was 182 and 147, respectively. The recommendation class distribution of the ACC/AHA guidelines was 61.0% class I (compared with 61.9% in the ESC guidelines, P=0.865), 29.7% class II (compared with 32.0% in the ESC guidelines, P=0.653), and 9.3% class III (compared with 6.1% in the ESC guidelines, P=0.282). The LOE distribution among ACC/AHA guidelines was 15.9% LOE A (compared with 27.9% in the ESC guidelines, P=0.008), 50.0% LOE B (compared with 33.3% in the ESC guidelines, P=0.002), and 34.1% LOE C (compared with 38.8% in the ESC guidelines, P=0.377). The ACC/AHA guidelines cited 827 publications and the ESC guidelines cited 551 publications, 124 of which were shared by both sets of guidelines. The guidelines' approaches to NSTE-ACS were consistent, with minor differences in diagnostic and medical therapy recommendations.
  
  
  CONCLUSIONS
  Overall, the ACC/AHA and ESC guidelines contain a comparable number of recommendations and provide similar guidance for the management of patients with NSTE-ACS.
authors.affiliation: aVA North Texas Healthcare System, UT Southwestern Medical Center, Dallas bMichael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas cAbbott Northwestern Hospital, Minneapolis Heart Institute, Minneapolis, Minnesota, USA.
authors.forename: Aya J
authors.initials: AJ
authors.lastname: Alame
authors.forename: Aris
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authors.lastname: Karatasakis
authors.forename: Judit
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authors.lastname: Karacsonyi
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Danek
authors.forename: Erica
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authors.lastname: Resendes
authors.forename: Jose R
authors.initials: JR
authors.lastname: Martinez Parachini
authors.forename: Pratik
authors.initials: P
authors.lastname: Kalsaria
authors.forename: Michele
authors.initials: M
authors.lastname: Roesle
authors.forename: Bavana V
authors.initials: BV
authors.lastname: Rangan
authors.forename: Paul
authors.initials: P
authors.lastname: Sorajja
authors.forename: Hani
authors.initials: H
authors.lastname: Jneid
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000628:therapy*; D000572:American Heart Association; D002309:Cardiology; D019468:Disease Management; D004562:Electrocardiography; D005060:Europe; D006801:Humans; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D014481:United States