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(Circulation. 1999;99:2829-2848.)
© 1999 American Heart Association, Inc.
ACC/AHA/ACP--ASIM Practice Guidelines |
ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina: Executive Summary and Recommendations
A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina)
Key Words: AHA Scientific Statements • angina • coronary artery disease • myocardial infarction
I. Introduction
A. Organization of Committee and Evidence Review
The American College of Cardiology/American Heart
Association (ACC/AHA) Task Force on Practice Guidelines was formed to
make recommendations regarding the diagnosis and treatment of patients
with known or suspected cardiovascular disease.
Ischemic heart disease is the single leading cause of death in
the United States. The most common manifestation of this disease is
chronic stable angina. Recognizing the importance of the management of
this common entity and the absence of national clinical practice
guidelines in this area, the task force formed the Committee on
Management of Patients With Chronic Stable Angina to develop guidelines
for the management of stable angina. Because this problem is frequently
encountered in the practice of internal medicine, the task force
invited the American College of Physicians–American Society of
Internal Medicine (ACP–ASIM) to serve as a partner in this effort by
identifying 3 general internists to serve on the committee.
The guidelines are arbitrarily divided into 4 sections: diagnosis, risk stratification, treatment, and patient follow-up. Experienced clinicians will quickly recognize that the distinctions between these sections may be arbitrary and unrealistic for individual patients. However, for most clinical decision making, these divisions are helpful and facilitate the presentation and analysis of the available evidence. Detailed evidence was developed whenever possible.
The weight of the evidence was ranked highest (A) if the data were
derived from multiple randomized clinical trials involving large
numbers of patients and intermediate (B) if the data were derived from
a limited number of randomized trials involving small numbers of
patients or careful
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