National Heart Foundation of Australia & Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the Management of Acute Coronary Syndromes 2016

Australian Commission on Safety and Quality in Health Care. Acute Coronary Syndromes Clinical Care Standard. 2014. Available at: http://www.safetyandquality.gov.au/our-work/clinical-care-standards/acute-coronary-syndromes-clinical-care-standard/. Accessed 30/3/16

National Heart Foundation of Australia. Australian acute coronary syndromes capability framework. 2015. Available at: https://heartfoundation.org.au/for-professionals/clinical-information/acute-coronary-syndromes. Accessed 30/3/16.

Australian Institute of Health and Welfare. Cardiovascular disease, diabetes and chronic kidney disease—Australian facts: Prevalence and incidence. Cardiovascular, diabetes and chronic kidney disease series no. 2.(Cat. no. CDK 2.)

Bhuiya, 2010, Emergency department visits for chest pain and abdominal pain: United States, 1999-2008, NCHS data brief., 1

Cullen, 2015, Cost and outcomes of assessing patients with chest pain in an Australian emergency department, Med J Aust., 202, 427, 10.5694/mja14.00472

Kelly, 2012, How useful are the Heart Foundation risk criteria for assessment of emergency department patients with chest pain?, EMA., 24, 260

Macdonald, 2011, Comparison of two clinical scoring systems for emergency department risk stratification of suspected acute coronary syndrome, Emergency Medicine Australasia: EMA., 23, 717, 10.1111/j.1742-6723.2011.01480.x

Aroney, 2008, 2007 addendum to the National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand Guidelines for the management of acute coronary syndromes 2006, Med J Aust., 188, 302, 10.5694/j.1326-5377.2008.tb01626.x

Chew, 2011, 2011 Addendum to the National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand Guidelines for the management of acute coronary syndromes (ACS) 2006, Heart Lung Circ., 20, 487, 10.1016/j.hlc.2011.03.008

2006, Guidelines for the management of acute coronary syndromes 2006, Med J Aust., 184, S1

Scott, 2014, Suggestions for improving guideline utility and trustworthiness, Evidence-based Medicine., 19, 41, 10.1136/eb-2013-101634

Guyatt, 2008, GRADE: an emerging consensus on rating quality of evidence and strength of recommendations, BMJ, 336, 924, 10.1136/bmj.39489.470347.AD

National Health and Medical Research Council. NHMRC additional levels of evidence and grades for recommendations for developers of guidelines. 2009. Available at: https://www.nhmrc.gov.au/_files_nhmrc/file/guidelines/developers/nhmrc_levels_grades_evidence_120423.pdf. Accessed on 30/3/16.

Pope, 2000, Missed diagnoses of acute cardiac ischemia in the emergency department, N Engl J Med., 342, 1163, 10.1056/NEJM200004203421603

Montassier, 2012, Outcome of chest pain patients discharged from a French emergency department: a 60-day prospective study, J Emerg Med., 42, 341, 10.1016/j.jemermed.2010.11.036

Schull, 2006, The Risk of Missed Diagnosis of Acute Myocardial Infarction Associated With Emergency Department Volume, Ann Emerg Med, 48, 647, 10.1016/j.annemergmed.2006.03.025

Diercks, 2006, Frequency and consequences of recording an electrocardiogram >10minutes after arrival in an emergency room in non-ST-segment elevation acute coronary syndromes (from the CRUSADE Initiative), Am J Cardiol., 97, 437, 10.1016/j.amjcard.2005.09.073

Terkelsen, 2002, Telemedicine used for remote prehospital diagnosing in patients suspected of acute myocardial infarction, Journal of Internal Medicine., 252, 412, 10.1046/j.1365-2796.2002.01051.x

Adams, 2006, Effectiveness of prehospital wireless transmission of electrocardiograms to a cardiologist via hand-held device for patients with acute myocardial infarction (from the Timely Intervention in Myocardial Emergency, NorthEast Experience [TIME-NE]), Am J Cardiol., 98, 1160, 10.1016/j.amjcard.2006.05.042

Welsford, 2015, Part 5: Acute Coronary Syndromes 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, Circulation., 132

Cabello, 2013, Oxygen therapy for acute myocardial infarction, The Cochrane database of systematic reviews., 8, CD007160

Stub, 2015, Air Versus Oxygen in ST-Segment-Elevation Myocardial Infarction, Circulation., 131, 2143, 10.1161/CIRCULATIONAHA.114.014494

Hofmann, 2014, DETermination of the role of OXygen in suspected Acute Myocardial Infarction trial, Am Heart J., 167, 322, 10.1016/j.ahj.2013.09.022

Khoshnood, 2015, The Effects of Oxygen Therapy on Myocardial Salvage in ST Elevation Myocardial Infarction Treated with Acute Percutaneous Coronary Intervention: The Supplemental Oxygen in Catheterized Coronary Emergency Reperfusion (SOCCER) Study, Cardiology., 132, 16, 10.1159/000398786

Gislason, 2006, Risk of death or reinfarction associated with the use of selective cyclooxygenase-2 inhibitors and nonselective nonsteroidal antiinflammatory drugs after acute myocardial infarction, Circulation., 113, 2906, 10.1161/CIRCULATIONAHA.106.616219

Kearney, 2006, Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials, BMJ., 332, 1302, 10.1136/bmj.332.7553.1302

George, 2013, Introduction of an accelerated diagnostic protocol in the assessment of emergency department patients with possible acute coronary syndrome: the Nambour Short Low-Intermediate Chest pain project, EMA., 25, 340

Antman, 2000, The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making, JAMA., 284, 835, 10.1001/jama.284.7.835

Fox, 2006, Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE), BMJ., 333, 1091, 10.1136/bmj.38985.646481.55

Six, 2013, The HEART score for the assessment of patients with chest pain in the emergency department: a multinational validation study, Crit Pathw Cardiol., 12, 121, 10.1097/HPC.0b013e31828b327e

Than, 2014, Development and validation of the Emergency Department Assessment of Chest pain Score and 2h accelerated diagnostic protocol, EMA., 26, 34

Body, 2014, The Manchester Acute Coronary Syndromes (MACS) decision rule for suspected cardiac chest pain: derivation and external validation, Heart., 100, 1462, 10.1136/heartjnl-2014-305564

Pollack, 2006, Application of the TIMI risk score for unstable angina and non-ST elevation acute coronary syndrome to an unselected emergency department chest pain population, Academic Emergency Medicine., 13, 13, 10.1111/j.1553-2712.2006.tb00978.x

Lyon, 2007, Chest pain presenting to the Emergency Department - to stratify risk with GRACE or TIMI?, Resuscitation., 74, 90, 10.1016/j.resuscitation.2006.11.023

Campbell, 2009, Combining Thrombolysis in Myocardial Infarction risk score and clear-cut alternative diagnosis for chest pain risk stratification, AJEM., 27, 37, 10.1016/j.ajem.2008.01.028

Cullen, 2013, Comparison of three risk stratification rules for predicting patients with acute coronary syndrome presenting to an australian emergency department, Heart Lung Circ., 22, 844, 10.1016/j.hlc.2013.03.074

Marcoon, 2013, HEART score to further risk stratify patients with low TIMI scores. Critical Pathways in Cardiology, A Journal of Evidence-Based Medicine., 12, 1

Goodacre, 2012, Evaluation of Global Registry of Acute Cardiac Events and Thrombolysis in Myocardial Infarction scores in patients with suspected acute coronary syndrome, AJEM., 30, 37, 10.1016/j.ajem.2010.09.013

Kelly, 2015, External validation of the GRACE Freedom from Events score in an emergency department ‘rule out ACS’ chest pain cohort, Int J Cardiol., 179, 358, 10.1016/j.ijcard.2014.11.076

Bajaj, 2013, Treatment and Outcomes of Patients With Suspected Acute Coronary Syndromes in Relation to Initial Diagnostic Impressions (Insights from the Canadian Global Registry of Acute Coronary Events [GRACE] and Canadian Registry of Acute Coronary Events [CANRACE]), Am J Cardiol., 111, 202, 10.1016/j.amjcard.2012.09.018

Six, 2008, Chest pain in the emergency room: value of the HEART scor, Netherlands Heart Journal: monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation., 16, 191, 10.1007/BF03086144

Mahler, 2011, Can the HEART score safely reduce stress testing and cardiac imaging in patients at low risk for major adverse cardiac events?, Crit Pathw Cardiol., 10, 128, 10.1097/HPC.0b013e3182315a85

Than, 2012, 2-Hour accelerated diagnostic protocol to assess patients with chest pain symptoms using contemporary troponins as the only biomarker: the ADAPT trial, JACC., 59, 2091, 10.1016/j.jacc.2012.02.035

Jellema, 2014, The value of clinical and laboratory diagnostics for chest pain patients at the emergency department, Clinical chemistry and laboratory medicine [Internet], 52, 259

Mahler, 2013, Identifying patients for early discharge: performance of decision rules among patients with acute chest pain, Int J Cardiol., 168, 795, 10.1016/j.ijcard.2012.10.010

Hess, 2012, Development of a clinical prediction rule for 30-day cardiac events in emergency department patients with chest pain and possible acute coronary syndrome, Ann Emerg Med., 59, 10.1016/j.annemergmed.2011.07.026

Willemsen, 2015, Diagnosing Acute Coronary Syndrome: A Challenge for General Practitioners and Cardiologists, Emerg Med (Los Angel), 5, 242

Mahler, 2015, The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge, Circ Cardiovasc Qual Outcomes., 8, 195, 10.1161/CIRCOUTCOMES.114.001384

Cullen, 2013, Validation of high-sensitivity troponin I in a 2-hour diagnostic strategy to assess 30-day outcomes in emergency department patients with possible acute coronary syndrome, JACC., 62, 1242, 10.1016/j.jacc.2013.02.078

Than, 2013, What is an acceptable risk of major adverse cardiac event in chest pain patients soon after discharge from the Emergency Department?: a clinical survey, Int J Cardiol., 166, 752, 10.1016/j.ijcard.2012.09.171

Pierce, 2010, The Chest Pain Choice trial: a pilot randomized trial of a decision aid for patients with chest pain in the emergency department, Trials., 11, 57, 10.1186/1745-6215-11-57

Hess, 2012, The chest pain choice decision aid: a randomized trial, Circ Cardiovasc Qual Outcomes., 5, 251, 10.1161/CIRCOUTCOMES.111.964791

Thygesen, 2012, Third universal definition of myocardial infarction, Circulation., 126, 2020, 10.1161/CIR.0b013e31826e1058

Reichlin, 2009, Early diagnosis of myocardial infarction with sensitive cardiac troponin assays, N Engl J Med., 361, 858, 10.1056/NEJMoa0900428

Lipinski, 2015, Comparison of conventional high-sensitivity troponin in patients with chest pain: a collaborative meta-analysis, Am Heart J., 169, 10.1016/j.ahj.2014.10.007

Sandoval, 2015, Diagnosis of type 1 and type 2 myocardial infarction using a high-sensitivity cardiac troponin I assay with sex-specific 99th percentiles based on the third universal definition of myocardial infarction classification system, Clinical Chemistry., 61, 657, 10.1373/clinchem.2014.236638

Aldous, 2012, High-sensitivity troponin T for early rule-out of myocardial infarction in recent onset chest pain, Emergency Medicine Journal., 29, 805, 10.1136/emermed-2011-200222

Aldous, 2012, A new improved accelerated diagnostic protocol safely identifies low-risk patients with chest pain in the emergency department, Academic Emergency Medicine., 19, 510, 10.1111/j.1553-2712.2012.01352.x

Storrow, 2015, Absolute and relative changes (delta) in troponin I for early diagnosis of myocardial infarction: Results of a prospective multicenter trial, Clin Biochem., 48, 260, 10.1016/j.clinbiochem.2014.09.012

Storrow, 2015, Diagnostic performance of cardiac Troponin I for early rule-in and rule-out of acute myocardial infarction: Results of a prospective multicenter trial, Clin Biochem., 48, 254, 10.1016/j.clinbiochem.2014.08.018

Goodacre, 2013, Systematic review, meta-analysis and economic modelling of diagnostic strategies for suspected acute coronary syndrome, Health Technology Assessment., 17, 1, 10.3310/hta17010

Hammarsten, 2012, Troponin T percentiles from a random population sample, emergency room patients and patients with myocardial infarction, Clinical Chemistry., 58, 628, 10.1373/clinchem.2011.171496

Cullen, 2014, Comparison of high sensitivity troponin T and I assays in the diagnosis of non-ST elevation acute myocardial infarction in emergency patients with chest pain, Clin Biochem., 47, 321, 10.1016/j.clinbiochem.2013.11.019

Rubini Gimenez, 2014, Direct comparison of high-sensitivity-cardiac troponin I vs T for the early diagnosis of acute myocardial infarction, Eur Heart J., 35, 2303, 10.1093/eurheartj/ehu188

Pretorius, 2014, Towards a consistent definition of a significant delta troponin with z-scores: a way out of chaos?, Europ Heart J Acute Cardiovasc Care., 3, 149, 10.1177/2048872613517084

Reichlin, 2011, Utility of absolute and relative changes in cardiac troponin concentrations in the early diagnosis of acute myocardial infarction, Circulation., 124, 136, 10.1161/CIRCULATIONAHA.111.023937

Apple, 2012, Delta cardiac troponin values in practice: are we ready to move absolutely forward to clinical routine?, Clinical Chemistry., 58, 8, 10.1373/clinchem.2011.175414

Al-Saleh, 2014, Performance of the high-sensitivity troponin assay in diagnosing acute myocardial infarction: systematic review and meta-analysis, CMAJ Open., 2, E199, 10.9778/cmajo.20130074

Apple, 2009, A new season for cardiac troponin assays: it's time to keep a scorecard, Clinical Chemistry., 55, 1303, 10.1373/clinchem.2009.128363

Diercks, 2012, Diagnostic accuracy of a point-of-care troponin I assay for acute myocardial infarction within 3hours after presentation in early presenters to the emergency department with chest pain, Am Heart J., 163, 10.1016/j.ahj.2011.09.028

Venge, 2010, Early and late outcome prediction of death in the emergency room setting by point-of-care and laboratory assays of cardiac troponin I, Am Heart J., 160, 835, 10.1016/j.ahj.2010.07.036

Mueller, 2014, Biomarkers and acute coronary syndromes: an update, Eur Heart J., 35, 552, 10.1093/eurheartj/eht530

Ter Avest, 2014, Point-of-care troponinT is inferior to high-sensitivity troponinT for ruling out acute myocardial infarction in the emergency department, European Journal of Emergency Medicine.

Keller, 2011, Serial changes in highly sensitive troponin I assay and early diagnosis of myocardial infarction, JAMA., 306, 2684, 10.1001/jama.2011.1896

Hoeller, 2013, Normal presenting levels of high-sensitivity troponin and myocardial infarction, Heart (British Cardiac Society) [Internet]., 99, 1567

Kelly, 2011, Performance of a sensitive troponin assay in the early diagnosis of acute myocardial infarction in the emergency department, EMA., 23, 181

Body, 2011, Rapid exclusion of acute myocardial infarction in patients with undetectable troponin using a high-sensitivity assay. [Erratum appears in J Am Coll Cardiol 2012 Sep 18 60 (12)1122], JACC, 58, 1332, 10.1016/j.jacc.2011.06.026

Shah, 2015, High-sensitivity cardiac troponin I at presentation in patients with suspected acute coronary syndrome: a cohort study, Lancet., 10.1016/S0140-6736(15)00391-8

Giannitsis, 2010, High-sensitivity cardiac troponin T for early prediction of evolving non-ST-segment elevation myocardial infarction in patients with suspected acute coronary syndrome and negative troponin results on admission, Clinical Chemistry., 56, 642, 10.1373/clinchem.2009.134460

Rubini Gimenez, 2013, Rapid rule out of acute myocardial infarction using undetectable levels of high-sensitivity cardiac troponin, Int J Cardiol [Internet]., 168, 3896, 10.1016/j.ijcard.2013.06.049

Bandstein, 2014, Undetectable High-Sensitivity Cardiac Troponin T Level in the Emergency Department and Risk of Myocardial Infarction, JACC., 63, 2569, 10.1016/j.jacc.2014.03.017

Zhelev, 2015, Diagnostic accuracy of single baseline measurement of Elecsys Troponin T high-sensitive assay for diagnosis of acute myocardial infarction in emergency department: systematic review and meta-analysis, BMJ., 350, h15, 10.1136/bmj.h15

Reichlin, 2015, Prospective validation of a 1-hour algorithm to rule-out and rule-in acute myocardial infarction using a high-sensitivity cardiac troponin T assay, CMAJ., 187, E243, 10.1503/cmaj.141349

Rubini Gimenez, 2015, One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I, Am J Med, 128, 10.1016/j.amjmed.2015.01.046

Reichlin, 2015, Two-hour Algorithm for Triage Toward Rule-out and Rule-in of Acute Myocardial Infarction Using High-sensitivity Cardiac Troponin T, Am J Med., 128, 369, 10.1016/j.amjmed.2014.10.032

Mueller, 2016, Multicenter Evaluation of a 0-Hour/1-Hour Algorithm in the Diagnosis of Myocardial Infarction With High-Sensitivity Cardiac Troponin T, Ann Emerg Med., 10.1016/j.annemergmed.2015.11.013

Body, 2015, High-sensitivity cardiac troponin t concentrations below the limit of detection to exclude acute myocardial infarction: a prospective evaluation, Clinical Chemistry., 61, 983, 10.1373/clinchem.2014.231530

Body, 2015, Rapid exclusion of acute myocardial infarction in patients with undetectable troponin using a sensitive troponin I assay, Ann Clin Biochem., 52, 543, 10.1177/0004563215576976

Rubini Gimenez, 2015, One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I, Am J Med., 128, 10.1016/j.amjmed.2015.01.046

Reichlin, 2012, One-hour rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T, Arch Intern Med, 172, 1211, 10.1001/archinternmed.2012.3698

Trambas, 2016, Impact of High-Sensitivity Troponin I Testing with Sex-Specific Cutoffs on the Diagnosis of Acute Myocardial Infarction, Clinical Chemistry, 10.1373/clinchem.2015.252569

Shah, 2015, High sensitivity cardiac troponin and the under-diagnosis of myocardial infarction in women: prospective cohort study, BMJ, 350, g7873, 10.1136/bmj.g7873

Aw, 2013, Measurement of cardiac troponin I in serum with a new high-sensitivity assay in a large multi-ethnic Asian cohort and the impact of gender, International Journal of Clinical Chemistry., 422, 26

Scott, 2014, Limited utility of exercise stress testing in the evaluation of suspected acute coronary syndrome in patients aged less than 40 years with intermediate risk features, EMA., 26, 170

Hermann, 2009, The limited utility of routine cardiac stress testing in emergency department chest pain patients younger than 40 years, Ann Emerg Med., 54, 12, 10.1016/j.annemergmed.2009.01.006

Greenslade, 2015, Utility of Routine Exercise Stress Testing among Intermediate Risk Chest Pain Patients Attending an Emergency Department, Heart Lung Circ., 24, 879, 10.1016/j.hlc.2015.03.025

Shah, 2013, Incremental diagnostic and prognostic value of contemporary stress echocardiography in a chest pain unit: mortality and morbidity outcomes from a real-world setting, Circulation Cardiovascular Imaging., 6, 202, 10.1161/CIRCIMAGING.112.980797

Sicari, 2009, Stress Echocardiography Expert Consensus Statement--Executive Summary: European Association of Echocardiography (EAE) (a registered branch of the ESC), Eur Heart J., 30, 278, 10.1093/eurheartj/ehn492

Athappan, 2010, Multi-detector computerized tomography angiography for evaluation of acute chest pain - A meta analysis and systematic review of literature, Int J Cardiol., 141, 132, 10.1016/j.ijcard.2008.11.207

Stein, 2000, Safety and utility of exercise testing in emergency room chest pain centers: An advisory from the Committee on Exercise, Rehabilitation, and Prevention Council on Clinical Cardiology, American Heart Association, Circulation, 102, 1463, 10.1161/01.CIR.102.12.1463

Abdulla, 2007, 64-Multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: A systematic review and meta-analysis, Eur Heart J., 28, 3042, 10.1093/eurheartj/ehm466

Ayaram, 2013, Triple rule-out computed tomographic angiography for chest pain: a diagnostic systematic review and meta-analysis, Academic Emergency Medicine., 20, 861, 10.1111/acem.12210

Li, 2013, Diagnostic accuracy of 320-slice computed tomography angiography for detection of coronary artery stenosis: Meta-analysis, Int J Cardiol., 168, 2699, 10.1016/j.ijcard.2013.03.023

von Ballmoos, 2011, Meta-analysis: diagnostic performance of low-radiation-dose coronary computed tomography angiography.[Erratum appears in Ann Intern Med 2011 Jun 21;154(12):848], Ann Intern Med., 154, 413, 10.7326/0003-4819-154-6-201103150-00007

Achenbach, 2008, Randomized comparison of 64-slice single- and dual-source computed tomography coronary angiography for the detection of coronary artery disease, ACC Cardiosource Review Journal., 17, 64

European Society of Cardiology (ESC) Task Force, 2013, 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology, Eur Heart J., 34, 2949, 10.1093/eurheartj/eht296

Paech, 2011, A systematic review of the clinical effectiveness of 64-slice or higher computed tomography angiography as an alternative to invasive coronary angiography in the investigation of suspected coronary artery disease, BMC Cardiovascular Disorders., 11

Than, 2014, A 2-hour diagnostic protocol for possible cardiac chest pain in the emergency department: a randomized clinical trial, JAMA Internal Medicine., 174, 51, 10.1001/jamainternmed.2013.11362

White, 2008, Acute myocardial infarction, Lancet., 372, 570, 10.1016/S0140-6736(08)61237-4

Alpert, 2014, Diagnostic and therapeutic implications of type 2 myocardial infarction: review and commentary, Am J Med., 127, 105, 10.1016/j.amjmed.2013.09.031

Chew, 2015, High sensitivity-troponin elevation secondary to non-coronary diagnoses and death and recurrent myocardial infarction: An examination against criteria of causality, European Heart Journal Acute Cardiovascular Care., 4, 419, 10.1177/2048872614564083

Morrow, 2000, TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy, Circulation., 102, 2031, 10.1161/01.CIR.102.17.2031

Chew, 2013, Perceived risk of ischemic and bleeding events in acute coronary syndromes, Circ Cardiovasc Qual Outcomes., 6, 299, 10.1161/CIRCOUTCOMES.111.000072

Mehran, 2010, A risk score to predict bleeding in patients with acute coronary syndromes, JACC., 55, 2556, 10.1016/j.jacc.2009.09.076

Subherwal, 2009, Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score, Circulation., 119, 1873, 10.1161/CIRCULATIONAHA.108.828541

Yan, 2007, Management patterns in relation to risk stratification among patients with non-ST elevation acute coronary syndromes, Arch Intern Med., 167, 1009, 10.1001/archinte.167.10.1009

Scott, 2007, Discordance between level of risk and intensity of evidence-based treatment in patients with acute coronary syndromes, Med J Aust., 187, 153, 10.5694/j.1326-5377.2007.tb01173.x

Yan, 2006, Underuse of evidence-based treatment partly explains the worse clinical outcome in diabetic patients with acute coronary syndromes, Am Heart J., 152, 676, 10.1016/j.ahj.2006.04.002

Chew, 2014, An examination of clinical intuition in risk assessment among acute coronary syndromes patients: observations from a prospective multi-center international observational registry, Int J Cardiol., 171, 209, 10.1016/j.ijcard.2013.12.010

1994, The Lancet, 343, 311, 10.1016/S0140-6736(94)91161-4

Boersma, 2006, Primary Coronary Angioplasty vs. Thrombolysis Group. Does time matter?. A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients, Eur Heart J., 27, 779, 10.1093/eurheartj/ehi810

Keeley, 2003, Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials, Lancet., 361, 13, 10.1016/S0140-6736(03)12113-7

De Luca, 2008, Transferring Patients With ST-Segment Elevation Myocardial Infarction for Mechanical Reperfusion: A Meta-Regression Analysis of Randomized Trials, Ann Emerg Med., 52, 665, 10.1016/j.annemergmed.2008.08.033

Pinto, 2011, Benefit of transferring ST-segment-elevation myocardial infarction patients for percutaneous coronary intervention compared with administration of onsite fibrinolytic declines as delays increase, Circulation., 124, 2512, 10.1161/CIRCULATIONAHA.111.018549

Bonnefoy, 2009, Comparison of primary angioplasty and pre-hospital fibrinolysis in acute myocardial infarction (CAPTIM) trial: a 5-year follow-up, Eur Heart J., 30, 1598, 10.1093/eurheartj/ehp156

Westerhout, 2011, The influence of time from symptom onset and reperfusion strategy on 1-year survival in ST-elevation myocardial infarction: a pooled analysis of an early fibrinolytic strategy versus primary percutaneous coronary intervention from CAPTIM and WEST, Am Heart J., 161, 283, 10.1016/j.ahj.2010.10.033

Armstrong, 2013, Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction, N Engl J Med., 368, 1379, 10.1056/NEJMoa1301092

Steg, 2003, Impact of time to treatment on mortality after prehospital fibrinolysis or primary angioplasty: data from the CAPTIM randomized clinical trial, Circulation., 108, 2851, 10.1161/01.CIR.0000103122.10021.F2

White, 2007, Enoxaparin vs. unfractionated heparin with fibrinolysis for ST-elevation myocardial infarction in elderly and younger patients: results from ExTRACT-TIMI 25, Eur Heart J., 28, 1066, 10.1093/eurheartj/ehm081

Jolly, 2015, Stroke in the TOTAL trial: a randomized trial of routine thrombectomy vs. percutaneous coronary intervention alone in ST elevation myocardial infarction, Eur Heart J., 36, 2364, 10.1093/eurheartj/ehv296

Mehta, 2012, RIVAL Investigators. Effects of radial versus femoral artery access in patients with acute coronary syndromes with or without ST-segment elevation, JACC, 60, 2490, 10.1016/j.jacc.2012.07.050

Barkagan, 2016, Impact of routine manual aspiration thrombectomy on outcomes of patients undergoing primary percutaneous coronary intervention for acute myocardial infarction: A meta-analysis, Int J Cardiol., 204, 189, 10.1016/j.ijcard.2015.11.135

Gershlick, 2015, Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial, JACC., 65, 963, 10.1016/j.jacc.2014.12.038

Wald, 2013, Randomized trial of preventive angioplasty in myocardial infarction, N Engl J Med., 369, 1115, 10.1056/NEJMoa1305520

Di Mario, 2008, Immediate angioplasty versus standard therapy with rescue angioplasty after thrombolysis in the Combined Abciximab REteplase Stent Study in Acute Myocardial Infarction (CARESS-in-AMI): an open, prospective, randomised, multicentre trial, Lancet., 371, 559, 10.1016/S0140-6736(08)60268-8

Cantor, 2009, Routine early angioplasty after fibrinolysis for acute myocardial infarction, N Engl J Med., 360, 2705, 10.1056/NEJMoa0808276

Borgia, 2010, Early routine percutaneous coronary intervention after fibrinolysis vs. standard therapy in ST-segment elevation myocardial infarction: a meta-analysis, Eur Heart J., 31, 2156, 10.1093/eurheartj/ehq204

Wijeysundera, 2007, Rescue angioplasty or repeat fibrinolysis after failed fibrinolytic therapy for ST-segment myocardial infarction: a meta-analysis of randomized trials, JACC., 49, 422, 10.1016/j.jacc.2006.09.033

White, 2008, Systems of care: need for hub-and-spoke systems for both primary and systematic percutaneous coronary intervention after fibrinolysis, Circulation., 118, 219, 10.1161/CIRCULATIONAHA.108.790170

Alfredsson, 2014, Impact of an invasive strategy on 5 years outcome in men and women with non-ST-segment elevation acute coronary syndromes, Am Heart J., 168, 522, 10.1016/j.ahj.2014.06.025

Damman, 2012, Circulation., 125, 568, 10.1161/CIRCULATIONAHA.111.061663

Fox, 2010, Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data, JACC., 55, 2435, 10.1016/j.jacc.2010.03.007

Hoenig, 2010, Early invasive versus conservative strategies for unstable angina and non-ST elevation myocardial infarction in the stent era, Cochrane Database of Systematic Reviews [Internet]., 10.1002/14651858.CD004815.pub3

O’Donoghue, 2008, Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis, JAMA., 300, 71, 10.1001/jama.300.1.71

Angeli, 2014, Early invasive versus selectively invasive strategy in patients with non-ST-segment elevation acute coronary syndrome: impact of age, Catheter Cardiovasc Interv., 83, 686, 10.1002/ccd.25307

Damman, 2012, Heart., 98, 207, 10.1136/heartjnl-2011-300453

Velazquez, 2011, Coronary-artery bypass surgery in patients with left ventricular dysfunction, N Engl J Med., 364, 1607, 10.1056/NEJMoa1100356

Navarese, 2011, Early vs. delayed invasive strategy in patients with acute coronary syndromes without ST-segment elevation: A meta-analysis of randomized studies, QJM., 104, 193, 10.1093/qjmed/hcq258

Navarese, 2013, Optimal timing of coronary invasive strategy in non-ST-segment elevation acute coronary syndromes: A systematic review and meta-analysis, Ann Intern Med., 158, 261, 10.7326/0003-4819-158-4-201302190-00006

Mehta, 2009, Early versus delayed invasive intervention in acute coronary syndromes, N Engl J Med., 360, 2165, 10.1056/NEJMoa0807986

Bangalore, 2014, Clinical Outcomes with b-Blockers for Myocardial Infarction: A Meta-analysis of Randomized Trials, Am J Med, 127, 939, 10.1016/j.amjmed.2014.05.032

2002, Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients, BMJ., 324, 71, 10.1136/bmj.324.7329.71

Current-Oasis Investigators, 2010, Dose comparisons of clopidogrel and aspirin in acute coronary syndromes, N Engl J Med, 363, 930, 10.1056/NEJMoa0909475

Yusuf, 2001, Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation, N Engl J Med., 345, 494, 10.1056/NEJMoa010746

Sabatine, 2005, Effect of clopidogrel pretreatment before percutaneous coronary intervention in patients with ST-elevation myocardial infarction treated with fibrinolytics: the PCI-CLARITY study, JAMA., 294, 1224, 10.1001/jama.294.10.1224

Wallentin, 2009, Ticagrelor versus clopidogrel in patients with acute coronary syndromes, N Engl J Med., 361, 1045, 10.1056/NEJMoa0904327

Wiviott, 2007, Prasugrel versus clopidogrel in patients with acute coronary syndromes, N Engl J Med., 357, 2001, 10.1056/NEJMoa0706482

Montalescot, 2013, Pretreatment with prasugrel in non-ST-segment elevation acute coronary syndromes, N Engl J Med., 369, 999, 10.1056/NEJMoa1308075

Montalescot, 2014, Prehospital ticagrelor in ST-segment elevation myocardial infarction, N Engl J Med., 371, 1016, 10.1056/NEJMoa1407024

Yeh, 2016, Development and Validation of a Prediction Rule for Benefit and Harm of Dual Antiplatelet Therapy Beyond 1 Year After Percutaneous Coronary Intervention, JAMA., 315, 1735, 10.1001/jama.2016.3775

Bonaca, 2015, Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction, N Engl J Med, 372, 1791, 10.1056/NEJMoa1500857

Mauri, 2014, Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents, N Engl J Med., 371, 2155, 10.1056/NEJMoa1409312

Levine, 2016, 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, JACC., 10.1016/j.jacc.2016.03.513

Briasoulis, 2016, Meta-Analysis of Oral Anticoagulants with Dual versus Single Antiplatelet Therapy in Patients after Percutaneous Coronary Intervention, American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions., 16, 103, 10.1007/s40256-015-0154-z

Bosch, 2013, Platelet glycoprotein IIb/IIIa blockers during percutaneous coronary intervention and as the initial medical treatment of non-ST segment elevation acute coronary syndromes, Cochrane Database of Systematic Reviews., 11, CD002130

Roffi, 2002, Platelet glycoprotein IIb/IIIa inhibition in acute coronary syndromes. Gradient of benefit related to the revascularization strategy, Eur Heart J., 23, 1441, 10.1053/euhj.2002.3160

Montalescot, 2001, Platelet glycoprotein IIb/IIIa inhibition with coronary stenting for acute myocardial infarction, N Engl J Med., 344, 1895, 10.1056/NEJM200106213442503

ten Berg, 2010, Effect of early, pre-hospital initiation of high bolus dose tirofiban in patients with ST-segment elevation myocardial infarction on short- and long-term clinical outcome, JACC., 55, 2446, 10.1016/j.jacc.2009.11.091

Kastrati, 2006, Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial, JAMA., 295, 1531, 10.1001/jama.295.13.joc60034

Andrade-Castellanos, 2014, Heparin versus placebo for non-ST elevation acute coronary syndromes, Cochrane Database of Systematic Reviews [Internet]., fa478

Silvain, 2012, Efficacy and safety of enoxaparin versus unfractionated heparin during percutaneous coronary intervention: systematic review and meta-analysis, BMJ., 344, e553, 10.1136/bmj.e553

Stone, 2008, Bivalirudin during primary PCI in acute myocardial infarction, N Engl J Med., 358, 2218, 10.1056/NEJMoa0708191

Steg, 2013, Bivalirudin started during emergency transport for primary PCI, N Engl J Med., 369, 2207, 10.1056/NEJMoa1311096

Valgimigli, 2015, Bivalirudin or Unfractionated Heparin in Acute Coronary Syndromes, N Engl J Med., 373, 997, 10.1056/NEJMoa1507854

Shahzad, 2014, Unfractionated heparin versus bivalirudin in primary percutaneous coronary intervention (HEAT-PPCI): an open-label, single centre, randomised controlled trial, Lancet., 384, 1849, 10.1016/S0140-6736(14)60924-7

Cavender, 2014, Bivalirudin versus heparin in patients planned for percutaneous coronary intervention: a meta-analysis of randomised controlled trials, Lancet., 384, 599, 10.1016/S0140-6736(14)61216-2

Mihaylova, 2012, The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials, Lancet., 380, 581, 10.1016/S0140-6736(12)60367-5

Navarese, 2014, Meta-analysis of time-related benefits of statin therapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention, Am J Cardiol., 113, 1753, 10.1016/j.amjcard.2014.02.034

Mampuya, 2013, Treatment strategies in patients with statin intolerance: the Cleveland Clinic experience, Am Heart J., 166, 597, 10.1016/j.ahj.2013.06.004

Cannon, 2015, Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes, N Engl J Med., 372, 2387, 10.1056/NEJMoa1410489

Dargie, 2001, Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial, Lancet., 357, 1385, 10.1016/S0140-6736(00)04560-8

Chen, 2000, Are beta-blockers effective in elderly patients who undergo coronary revascularization after acute myocardial infarction?, Arch Intern Med., 160, 947, 10.1001/archinte.160.7.947

Yusuf, 1985, Beta blockade during and after myocardial infarction: an overview of the randomized trials, Progress in Cardiovascular Diseases., 27, 335, 10.1016/S0033-0620(85)80003-7

Gottlieb, 1998, Effect of beta-blockade on mortality among high-risk and low-risk patients after myocardial infarction, N Engl J Med., 339, 489, 10.1056/NEJM199808203390801

Freemantle, 1999, Beta Blockade after myocardial infarction: systematic review and meta regression analysis, BMJ., 318, 1730, 10.1136/bmj.318.7200.1730

de Peuter, 2009, A systematic review of selective and non-selective beta blockers for prevention of vascular events in patients with acute coronary syndrome or heart failure, The Netherlands Journal of Medicine., 67, 284

Flather, 2000, Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients. ACE-Inhibitor Myocardial Infarction Collaborative Group, Lancet., 355, 1575, 10.1016/S0140-6736(00)02212-1

Dagenais, 2006, Angiotensin-converting-enzyme inhibitors in stable vascular disease without left ventricular systolic dysfunction or heart failure: a combined analysis of three trials, Lancet., 368, 581, 10.1016/S0140-6736(06)69201-5

National Heart Foundation of Australia. Guideline for the diagnosis and management of hypertension in adults – 2016. Melbourne: National Heart Foundation of Australia, 2016. Available at: http://heartfoundation.org.au/images/uploads/publications/PRO-167_Hypertension-guideline-2016_WEB.pdf Accessed 26/7/16.

Woodruffe, 2015, Australian Cardiovascular Health and Rehabilitation Association (ACRA) core components of cardiovascular disease secondary prevention and cardiac rehabilitation 2014, Heart Lung Circ., 24, 430, 10.1016/j.hlc.2014.12.008

Fletcher, 2013, Exercise standards for testing and training: a scientific statement from the American Heart Association, Circulation., 128, 873, 10.1161/CIR.0b013e31829b5b44

Anderson, 2016, Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease, JACC, 67, 1, 10.1016/j.jacc.2015.10.044

Clark, 2005, Meta-analysis: secondary prevention programs for patients with coronary artery disease, Ann Intern Med., 143, 659, 10.7326/0003-4819-143-9-200511010-00010

Redfern, 2011, Achieving coordinated secondary prevention of coronary heart disease for all in need (SPAN), Int J Cardiol., 146, 1, 10.1016/j.ijcard.2010.08.046

Briffa, 2009, An integrated and coordinated approach to preventing recurrent coronary heart disease events in Australia, Med J Aust., 190, 683, 10.5694/j.1326-5377.2009.tb02636.x

Chow, 2015, Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients With Coronary Heart Disease: A Randomized Clinical Trial, JAMA., 314, 1255, 10.1001/jama.2015.10945

Pfaeffli Dale, 2015, Text Message and Internet Support for Coronary Heart Disease Self-Management: Results From the Text4Heart Randomized Controlled Trial, Journal of Medical Internet Research., 17, e237, 10.2196/jmir.4944

Varnfield, 2014, Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial, Heart., 100, 1770, 10.1136/heartjnl-2014-305783

Scott, 2005, Variations in indicated care of patients with acute coronary syndromes in Queensland hospitals, Med J Aust., 182, 325, 10.5694/j.1326-5377.2005.tb06729.x

Burkett, 2014, A comparative analysis of risk stratification tools for emergency department patients with chest pain, Int J Emerg Med., 7, 10, 10.1186/1865-1380-7-10

Fesmire, 2012, Improving risk stratification in patients with chest pain: the Erlanger HEARTS(3) score, AJEM., 30, 1829, 10.1016/j.ajem.2012.03.017

Melki, 2013, HEART score: a simple and useful tool that may lower the proportion of chest pain patients who are admitted, Crit Pathw Cardiol., 12, 127, 10.1097/HPC.0b013e3182953359

Hess, 2010, Diagnostic accuracy of the TIMI risk score in patients with chest pain in the emergency department: a meta-analysis (Structured abstract), CMAJ: [Internet], 182, 1039, 10.1503/cmaj.092119

Hess, 2010, Prospective validation of a modified thrombolysis in myocardial infarction risk score in emergency department patients with chest pain and possible acute coronary syndrome, Academic Emergency Medicine., 17, 368, 10.1111/j.1553-2712.2010.00696.x

Backus, 2013, A prospective validation of the HEART score for chest pain patients at the emergency department, Int J Cardiol., 168, 2153, 10.1016/j.ijcard.2013.01.255

Backus, 2010, Chest pain in the emergency room: a multicenter validation of the HEART Score, Crit Pathw Cardiol., 9, 164, 10.1097/HPC.0b013e3181ec36d8

Kelly, 2012, External validation of the GRACE Freedom from Events score, Heart Lung Circ., 21, 582, 10.1016/j.hlc.2012.05.005

Body, 2015, The Manchester Acute Coronary Syndromes (MACS) decision rule: validation with a new automated assay for heart-type fatty acid binding protein, Emerg Med J, 32, 769, 10.1136/emermed-2014-204235

Meller, 2015, Accelerated diagnostic protocol using high-sensitivity cardiac troponinT in acute chest pain patients, IJC., 184, 208

Carlton, 2015, A novel diagnostic protocol to identify patients suitable for discharge after a single high-sensitivity troponin, Heart., 101, 1041, 10.1136/heartjnl-2014-307288

Fanaroff, 2015, Does This Patient With Chest Pain Have Acute Coronary Syndrome?: The Rational Clinical Examination Systematic Review, JAMA., 314, 1955, 10.1001/jama.2015.12735

2012, The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC) ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation, Eur Heart J., 33, 2569, 10.1093/eurheartj/ehs215

Neumann, 2014, Assessing the strength of recommendations: the GRADE approach, 561

Suggested citation: National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand. Australian clinical guidelines for the management of acute coronary syndromes 2016. Heart, Lung and Circulation, 25 (2016) pp 895–951.