PMID- 15457302
OWN - NLM
STAT- MEDLINE
DCOM- 20041108
LR  - 20080409
IS  - 0828-282X (Print)
IS  - 0828-282X (Linking)
VI  - 20
IP  - 11
DP  - 2004 Sep
TI  - The 2004 ACC/AHA Guidelines: a perspective and adaptation for Canada by the 
      Canadian Cardiovascular Society Working Group.
PG  - 1075-9
AB  - Major changes in acute ST elevation myocardial infarction (STEMI) management 
      prompted a comprehensive rewriting of the American College of Cardiology/American 
      Heart Association Guidelines. The Canadian Cardiovascular Society (CCS) 
      participated in both the writing process and the external review. Subsequently, a 
      Canadian Working Group (CWG), formed under the auspices of the CCS, developed a 
      perspective and adaptation for Canada. Herein, accounting for specific realities 
      of the Canadian cardiovascular health system, is a discussion of the implications 
      for prehospital care and transport, optimal reperfusion therapy and an approach 
      to decision making regarding reperfusion options and invasive therapy following 
      fibrinolytic therapy. Major recent developments regarding indications for 
      implantable cardioverter defibrillator(s) (ICDs) also prompted a review of 
      indications for ICDs and the optimal timing of implantation given the potential 
      for recovery of left ventricular function. At least a 40-day, preferably a 
      12-week, waiting period was judged to be optimal to evaluate left ventricular 
      function post-STEMI. A recommended algorithm for the insertion of an ICD is 
      provided. Implementation of the new STEMI guidelines has substantial implications 
      for resources, organization and priorities of the Canadian health care system. 
      While on the one hand, the necessary incremental funding to provide tertiary and 
      quaternary care and to support revascularization and device implantation 
      capability is desirable, it is equally or more important to develop enhanced 
      prehospital care, including the capacity for early recognition, risk assessment, 
      fibrinolytic therapy and/or triage to a tertiary care centre as part of an 
      enlightened approach to improving cardiac care.
FAU - Armstrong, Paul W
AU  - Armstrong PW
AD  - VIGOUR Centre, University of Alberta, Edmonton. paul.armstrong@ualberta.ca
FAU - Bogaty, Peter
AU  - Bogaty P
FAU - Buller, Christopher E
AU  - Buller CE
FAU - Dorian, Paul
AU  - Dorian P
FAU - O'Neill, Blair J
AU  - O'Neill BJ
CN  - Canadian Cardiovascular Society Working Group
LA  - eng
PT  - Comparative Study
PT  - Guideline
PT  - Journal Article
PT  - Practice Guideline
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
SB  - IM
MH  - Canada
MH  - Defibrillators, Implantable/*standards
MH  - Electrocardiography
MH  - Emergency Medical Services/standards
MH  - Emergency Service, Hospital/standards
MH  - Female
MH  - *Guideline Adherence
MH  - Humans
MH  - Male
MH  - Myocardial Infarction/diagnosis/*therapy
MH  - Myocardial Reperfusion/*standards
MH  - Severity of Illness Index
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 2004/10/01 05:00
MHDA- 2004/11/09 09:00
CRDT- 2004/10/01 05:00
PHST- 2004/10/01 05:00 [pubmed]
PHST- 2004/11/09 09:00 [medline]
PHST- 2004/10/01 05:00 [entrez]
PST - ppublish
SO  - Can J Cardiol. 2004 Sep;20(11):1075-9.