Evidence-based vs. ‘impressionist’ medicine: how best to implement guidelinesThe opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology.

European Society of Cardiology Practice Guidelines Committee. Recommendations for Task Force Creation and Report Production. A document for Task Force members and expert panels responsible for the creation and production of Guidelines and Expert Consensus Documents 2003. http://www.escardio.org/initiatives/guidelines/?related.

Fox KA, Goodman SG, Anderson FA, Granger CB, Moscucci M, Flather MD, Spencer F, Budaj A, Dabbous OH, Gore JM. From guidelines to clinical practice: the impact of hospital and geographical characteristics on temporal trends in the management of acute coronary syndromes. The Global Registry of Acute Coronary Events (GRACE). Eur Heart J2003;24:1414–1424.

Fox KA, Goodman SG, Klein W, Brieger D, Steg PG, Dabbous O, Avezum A. Management of acute coronary syndromes. Variations in practice and outcome; findings from the Global Registry of Acute Coronary Events (GRACE). Eur Heart J2002;23:1177–1189.

Hasdai D, Behar S, Wallentin L, Danchin N, Gitt AK, Boersma E, Fioretti PM, Simoons ML, Battler A. A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). Eur Heart J2002;23:1190–1201.

Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Assessment of the Safety and Efficacy of a New Thrombolytic Investigators. Lancet1999;354:716–722.

Assent-3 Investigators. Efficacy and safety of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: the ASSENT-3 randomised trial in acute myocardial infarction. Lancet2001;358:605–613.

Antman EM, McCabe CH, Gurfinkel EP, Turpie AG, Bernink PJ, Salein D, Bayes De Luna A, Fox K, Lablanche JM, Radley D, Premmereur J, Braunwald E. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wave myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) 11B trial. Circulation1999;100:1593–1601.

Cohen M, Demers C, Gurfinkel EP, Turpie AG, Fromell GJ, Goodman S, Langer A, Califf RM, Fox KA, Premmereur J, Bigonzi F. A comparison of low-molecular-weight heparin with unfractionated heparin for unstable coronary artery disease. Efficacy and safety of subcutaneous enoxaparin in non-Q-wave coronary events study group. N Engl J Med1997;337:447–452.

Gottwik M, Zahn R, Schiele R, Schneider S, Gitt AK, Fraunberger L, Bossaller C, Glunz HG, Altmann E, Rosahl W, Senges J. Differences in treatment and outcome of patients with acute myocardial infarction admitted to hospitals with compared to without departments of cardiology; results from the pooled data of the Maximal Individual Therapy in Acute Myocardial Infarction (MITRA 1+2) Registries and the Myocardial Infarction Registry (MIR). Eur Heart J2001;22:1794–1801.

Bhatt DL, Roe MT, Peterson ED, Li Y, Chen AY, Harrington RA, Greenbaum AB, Berger PB, Cannon CP, Cohen DJ, Gibson CM, Saucedo JF, Kleiman NS, Hochman JS, Boden WE, Brindis RG, Peacock WF, Smith SC Jr, Pollack CV Jr, Gibler WB, Ohman EM. Utilization of early invasive management strategies for high-risk patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE Quality Improvement Initiative. JAMA2004;292:2096–2104.

Stenestrand U, Wallentin L. Early revascularisation and 1-year survival in 14-day survivors of acute myocardial infarction: a prospective cohort study. Lancet2002;359:1805–1811.

Peterson ED, Pollack CV Jr, Roe MT, Parsons LS, Littrell KA, Canto JG, Barron HV. Early use of glycoprotein IIb/IIIa inhibitors in non-ST-elevation acute myocardial infarction: observations from the National Registry of Myocardial Infarction 4. J Am Coll Cardiol2003;42:45–53.

Hagemeister J, Schneider CA, Barabas S, Schadt R, Wassmer G, Mager G, Pfaff H, Hopp HW. Hypertension guidelines and their limitations–the impact of physicians' compliance as evaluated by guideline awareness. J Hypertens2001;19:2079–2086.

Hibble A, Kanka D, Pencheon D, Pooles F. Guidelines in general practice: the new Tower of Babel? BMJ1998;317:862–863.

Ezekowitz J, McAlister FA, Humphries KH, Norris CM, Tonelli M, Ghali WA, Knudtson ML. The association among renal insufficiency, pharmacotherapy, and outcomes in 6,427 patients with heart failure and coronary artery disease. J Am Coll Cardiol2004;44:1587–1592.

EUROASPIRE. A European Society of Cardiology survey of secondary prevention of coronary heart disease: principal results. EUROASPIRE Study Group. European action on secondary prevention through intervention to reduce events. Eur Heart J1997;18:1569–1582.

EUROASPIRE-II. Lifestyle and risk factor management and use of drug therapies in coronary patients from 15 countries; principal results from EUROASPIRE II Euro Heart Survey Programme. Eur Heart J2001;22:554–572.

Komajda M, Follath F, Swedberg K, Cleland J, Aguilar JC, Cohen-Solal A, Dietz R, Gavazzi A, Van Gilst WH, Hobbs R, Korewicki J, Madeira HC, Moiseyev VS, Preda I, Widimsky J, Freemantle N, Eastaugh J, Mason J. The EuroHeart Failure Survey programme–a survey on the quality of care among patients with heart failure in Europe. Part 2: treatment. Eur Heart J2003;24:464–474.

Califf RM, DeLong ER, Ostbye T, Muhlbaier LH, Chen A, LaPointe NA, Hammill BG, McCants CB, Kramer JM. Underuse of aspirin in a referral population with documented coronary artery disease. Am J Cardiol2002;89:653–661.

Budnitz D, Neuman WR. Underuse of beta-blockers following myocardial infarction. JAMA2001;285:1013.

Hemingway H, Crook AM, Feder G, Banerjee S, Dawson JR, Magee P, Philpott S, Sanders J, Wood A, Timmis AD. Underuse of coronary revascularization procedures in patients considered appropriate candidates for revascularization. N Engl J Med2001;344:645–654.

Hlatky MA. Underuse of evidence-based therapies. Circulation2004;110:644–645.

De Wilde S, Cook DG, Carey IM, Hilton SR, Whincup PH. Underuse of statins among older people. Lancet2003;362:746–747.

Schiele F, Meneveau N, Seronde MF, Caulfield F, Fouche R, Lassabe G, Baborier D, Legalery P, Bassand JP. Compliance with guidelines and 1-year mortality in patients with acute myocardial infarction. A prospective study. Eur Heart J2005, doi 10.1093/eurheartj/ehi107. Published online ahead of print January 28, 2005.

Steg PG, Bonnefoy E, Chabaud S, Lapostolle F, Dubien PY, Cristofini P, Leizorovicz A, Touboul P. Impact of time to treatment on mortality after prehospital fibrinolysis or primary angioplasty: data from the CAPTIM randomized clinical trial. Circulation2003;108:2851–2856.

Topol EJ. Reperfusion therapy for acute myocardial infarction with fibrinolytic therapy or combination reduced fibrinolytic therapy and platelet glycoprotein IIb/IIIa inhibition: the GUSTO V randomised trial. Lancet2001;357:1905–1914.

Ellis SG, Armstrong P, Betriu A, Brodie B, Herrmann H, Montalescot G, Neumann FJ, Smith JJ, Topol E. Facilitated percutaneous coronary intervention versus primary percutaneous coronary intervention: design and rationale of the Facilitated Intervention with Enhanced Reperfusion Speed to Stop Events (FINESSE) trial. Am Heart J2004;147:E16.

Yusuf S, Flather M, Pogue J, Hunt D, Varigos J, Piegas L, Avezum A, Anderson J, Keltai M, Budaj A, Fox K, Ceremuzynski L. Variations between countries in invasive cardiac procedures and outcomes in patients with suspected unstable angina or myocardial infarction without initial ST elevation. OASIS (Organisation to Assess Strategies for Ischaemic Syndromes) Registry Investigators. Lancet1998;352:507–514.

Priori SG, Klein W, Bassand JP. Medical Practice Guidelines. Separating science from economics. Eur Heart J2003;24:1962–1964.

Mehta RH, Montoye CK, Gallogly M, Baker P, Blount A, Faul J, Roychoudhury C, Borzak S, Fox S, Franklin M, Freundl M, Kline-Rogers E, LaLonde T, Orza M, Parrish R, Satwicz M, Smith MJ, Sobotka P, Winston S, Riba AA, Eagle KA. Improving quality of care for acute myocardial infarction: the Guidelines Applied in Practice (GAP) Initiative. JAMA2002;287:1269–1276.