Choosing Wisely Heart Attack Recommendations

 In light of new medical evidence, the American College of Cardiology (ACC) in September withdrew one of its five recommendations in the Choosing Wisely  campaign that heart attack patients question interventions beyond unblocking just the "culprit" artery responsible for the heart attack.

Choosing Wisely uses evidence-based lists developed by medical specialty societies to call physicians' and patients' attention to potentially overused tests and procedures that could harm rather than help patients ( The Texas Medical Association sees Choosing Wisely as a vehicle for quality improvement and is one of five state medical associations to win a grant to promote the campaign in partnership with the TMA Foundation.

ACC based its original recommendation on nonrandomized studies that, at the time, suggested treating all significantly blocked arteries in heart attack patients could be harmful.

"However, over the last two years, new science has emerged showing potential improvements for some patients in their overall outcomes as a result of complete revascularization," ACC says, pointing to two recent randomized controlled trials and a third under way.

"Science is not static, but rather constantly changing. As such, one of the ACC's primary roles is to stay abreast of this evolution and provide cardiovascular professionals and patients with the most up-to-date information on which to base decisions about the most appropriate and necessary treatment," ACC President Patrick T. O'Gara, MD, said. "The more access patients and providers have to accurate information about treatment options, the more we can ensure care that is truly necessary, free from harm, and cost-effective."

He says ACC's clinical guidelines and appropriate use criteria will address the new research, and the group will work with the ABIM Foundation to update its Choosing Wisely recommendations.

As part of the Choosing Wisely campaign, nearly 60 organizations have published lists of potentially unnecessary tests, treatments, and procedures that ABIM Foundation Executive Vice President and Chief Operating Officer Daniel Wolfson says are based on the latest science and evidence available at their time of publication. Choosing Wisely partners must review their list at least annually and make any needed updates based on new evidence or changes to clinical guidelines.

"The ABIM Foundation recognizes that new research and medical guidelines are published on a regular basis and has developed a set of operating principles to ensure the accuracy of all Choosing Wisely lists is maintained," he said.

Texas Medicine, Dec. 2014

Last Updated On

May 13, 2016

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