PMID- 37436514 OWN - NLM STAT- MEDLINE DCOM- 20240321 LR - 20240321 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 113 IP - 4 DP - 2024 Apr TI - Type of evidence supporting ACC/AHA and ESC clinical practice guidelines for acute coronary syndrome. PG - 546-560 LID - 10.1007/s00392-023-02262-9 [doi] AB - AIM: The aim of clinical practice guidelines for ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTE-ACS) is to assist healthcare professionals in clinical decision-making. We evaluated the type of studies supporting these guidelines and their recommendations. METHODS: All references and recommendations in the 2013 and 2014 ACC/AHA and 2017 and 2020 (ESC clinical guidelines for STEMI and NSTE-ACS were reviewed. References were classified into meta-analyses, randomised, non-randomised, and other types (e.g., position papers, reviews). Recommendations were classified according to class and their level of evidence (LOE). RESULTS: We retrieved 2128 non-duplicated references: 8.4% were meta-analyses, 26.2% randomised studies, 44.7% non-randomised studies, and 20.7% 'other' papers. Meta-analyses were based on randomised data in 78% of cases and used individual-patient data in 20.2%. Compared to non-randomised studies, randomised studies were more frequently multicentre (85.5% vs. 65.5%) and international (58.2% vs. 28.5%). The type of studies supporting recommendations varied as per the LOE of the recommendation. For LOE-A recommendations, the breakdown of supporting recommendations was: 18.5% meta-analyses, 56.6% randomised studies, 16.6% non-randomised studies and 8.3% 'other' papers; for LOE-B this breakdown was 9%, 39.8%, 38.2%, and 12.9%; and for LOE-C; 4.6%, 19.3%, 30.3%, and 45.9%. CONCLUSIONS: The references supporting the ACC/AHA and ESC guidelines on STEMI and NSTE-ACS consisted of non-randomised studies in ~ 45% of cases, with less than a third of the references consisting of meta-analyses and randomised studies. The type of studies supporting guideline recommendations varied widely by the LOE of the recommendation. CI - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany. FAU - Gonzalez-Del-Hoyo, Maribel AU - Gonzalez-Del-Hoyo M AD - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain. AD - Cardiology Department, Hospital Universitari Son Espases, Palma, Spain. FAU - Mas-Llado, Caterina AU - Mas-Llado C AD - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain. AD - Cardiology Department, Hospital de Manacor, Manacor, Spain. AD - Faculty of Medicine, Universitat de les Illes Balears (UIB), Palma, Spain. FAU - Blaya-Pena, Laura AU - Blaya-Pena L AD - Cardiology Department, Hospital Universitari Son Espases, Palma, Spain. FAU - Siquier-Padilla, Joan AU - Siquier-Padilla J AD - Cardiology Department, Hospital Universitari Son Espases, Palma, Spain. FAU - Coughlan, J J AU - Coughlan JJ AD - Deutsches Herzzentrum Munchen und Technische Universitat Munchen, Munich, Germany. AD - Cardiovascular Research Institute, Mater Private Network, Dublin, Ireland. FAU - Peral, Vicente AU - Peral V AD - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain. AD - Cardiology Department, Hospital Universitari Son Espases, Palma, Spain. AD - Faculty of Medicine, Universitat de les Illes Balears (UIB), Palma, Spain. FAU - Rossello, Xavier AU - Rossello X AUID- ORCID: 0000-0001-6783-8463 AD - Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain. fjrossello@ssib.es. AD - Cardiology Department, Hospital Universitari Son Espases, Palma, Spain. fjrossello@ssib.es. AD - Faculty of Medicine, Universitat de les Illes Balears (UIB), Palma, Spain. fjrossello@ssib.es. AD - Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. fjrossello@ssib.es. LA - eng PT - Journal Article DEP - 20230712 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - *Acute Coronary Syndrome/diagnosis/therapy MH - *ST Elevation Myocardial Infarction MH - Societies, Medical MH - Clinical Decision-Making OTO - NOTNLM OT - Acute coronary syndrome OT - Clinical Practice Guidelines OT - Evidence-based medicine OT - Recommendations EDAT- 2023/07/12 13:07 MHDA- 2024/03/21 12:43 CRDT- 2023/07/12 11:07 PHST- 2023/01/23 00:00 [received] PHST- 2023/06/29 00:00 [accepted] PHST- 2024/03/21 12:43 [medline] PHST- 2023/07/12 13:07 [pubmed] PHST- 2023/07/12 11:07 [entrez] AID - 10.1007/s00392-023-02262-9 [pii] AID - 10.1007/s00392-023-02262-9 [doi] PST - ppublish SO - Clin Res Cardiol. 2024 Apr;113(4):546-560. doi: 10.1007/s00392-023-02262-9. Epub 2023 Jul 12.