2012 Oman Heart Association Simplified Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

In 2012, Oman Heart Association (OHA) published its own guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction, the aim was not to be comprehensive but rather simplified and practical in order to reduce the gap between the long comprehensive guidelines and our actual practice. However, we still feel that the busy registrars and residents need simpler and direct clinical pathways or protocol to be used in the emergency departments, coronary care units and in the wards. Clinical pathways are now one of the main tools used to manage the quality in healthcare concerning the standardization of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes in acute care.

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“…1 The recommendations are similar to published international guidelines, 2-9 but suited for local physicians in a simplified manner.…”

Section: Introductionmentioning

confidence: 82%

Clinical Pathways for Non-ST Elevation Acute Coronary Syndrome in Oman: An Oman Heart Association Protocol for Hospital Quality Improvement Initiative

El-Deeb

Al-Riyami²,

Sulaiman

et al. 2014

Oman Med J

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“…[3] However, evidence shows that uptake of guidelines by clinicians is suboptimal. [4] Anecdotal experience in the laboratory was that clinicians were continuing to order cardiac troponin I (cTnI) together with the CK-MB isoform in cases of suspected ACS. We undertook a prospective audit of requests in the setting of chest pain to ascertain the validity of this suspicion.…”

mentioning

confidence: 99%

Clinicians ignore best practice guidelines: Prospective audit of cardiac injury marker ordering in patients with chest pain

Bellbhudder¹,

Stanfliet²

2014

S Afr Med J

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Background. Chest pain is a frequent presenting symptom and is a diagnostic challenge. Recent recommendations state that high-sensitivity cardiac troponin assays are the only biochemical test required in the diagnosis of acute coronary syndrome (ACS) and that other biomarkers such as myoglobin or creatine kinase (CK)-MB isoform are not indicated. Objective. To establish whether clinician ordering in the setting of suspected ACS was in keeping with recent recommendations. Methods. A prospective audit was undertaken of all requests for cardiac troponin I (cTnI) and CK-MB received at a large tertiary hospital in Durban, South Africa, during a 20-day period in December 2012. Results. A total of 193 cardiac marker requests were received: 12 (6.2%) requests were for cTnI alone; 8 (4.1%) were for CK-MB alone; and the remaining 173 (89.7%) were for both cTnI and CK-MB. Therefore, a total of 181 (93.8%) incorrect requests were received during this period. A total of 103 (53.4%) patients had values below the cut-off point of 40 ng/l for cTnI, i.e. ACS was ruled out. Of these, 15 had CK-MB values above the reference interval. A total of 12 (6.2%) patients had cTnI values>500 ng/l, i.e. ACS was ruled in; 33.3 % of this group had normal CK-MB values. Conclusion. Ordering patterns in the setting of ACS did not reflect current recommendations and were wasteful and potentially dangerous. S Afr Med J 2014;104(4):305-306. DOI:10.7196/SAMJ.7381 Chest pain is common and frequently presents a diagnostic challenge.[1] Acute coronary syndrom

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Challenges and solutions in medically managed ACS in the Asia-Pacific region: Expert recommendations from the Asia-Pacific ACS Medical Management Working Group

Huo

Thompson

Buddhari

et al. 2015

International Journal of Cardiology

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2012 Oman Heart Association Simplified Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

Cited by 4 publications

References 22 publications

Clinical Pathways for Non-ST Elevation Acute Coronary Syndrome in Oman: An Oman Heart Association Protocol for Hospital Quality Improvement Initiative

Clinical Pathways for Non-ST Elevation Acute Coronary Syndrome in Oman: An Oman Heart Association Protocol for Hospital Quality Improvement Initiative

Clinicians ignore best practice guidelines: Prospective audit of cardiac injury marker ordering in patients with chest pain

Challenges and solutions in medically managed ACS in the Asia-Pacific region: Expert recommendations from the Asia-Pacific ACS Medical Management Working Group

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