This document was developed by a consensus conference initiated by Kristian Thygesen, MD, and Joseph S. Alpert, MD, after formal approval by Lars Rydén, MD, President of the European Society of Cardiology (ESC), and Arthur Garson, MD, President of the American College of Cardiology (ACC). All of the participants were selected for their expertise in the field they represented, with approximately one-half of the participants selected from each organization. Participants were instructed to review the scientific evidence in their area of expertise and to attend the consensus conference with prepared remarks. The first draft of the document was prepared during the consensus conference itself. Sources of funding appear in Appendix A. The recommendations made in this document represent the attitudes and opinions of the participants at the time of the conference, and these recommendations were revised subsequently. The conclusions reached will undoubtedly need to be revised as new scientific evidence becomes available. This document has been reviewed by members of the ESC Committee for Scientific and Clinical Initiatives and by members of the Board of the ESC who approved the document on April 15, 2000.*
The Bogossian formula is a reliable tool for QTc interval evaluation in pacemaker patients with LBBB due to apical or non-apical RV pacing. However, an overestimation of 30 ms should be included in the calculation.
Unstable angina is a critical phase of coronary heart disease with a risk for myocardial infarction or death of up to 20% within 30 days. Glycoprotein IIb/IIIa antagonists are a new class of potent antiplatelet drugs. In several large randomized trials, it has been well established that the antibody abciximab, and the low molecular synthetic compounds tirofiban and eptifibatide, reduce the cardiac event rate by 10 to 70% in patients with and without percutaneous interventions. This effect was found to be predominately present in patients with elevated troponins. Accordingly, glycoprotein IIb/IIIa antagonists represent a major achievement for the treatment regimen of patients with unstable angina.
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