Evidence mapPaperPMID 39239072Full record

ArticleJournal of research in medical sciences : the official journal of Isfahan University of Medical Sciences2024

Development of the first Iranian clinical practice guidelines for the diagnosis, treatment, and secondary prevention of acute coronary syndrome.

Nizal Sarrafzadegan, Fahimeh Bagherikholenjani, Shahla Shahidi, Golsa Ghasemi, Ehsan Shirvani, Fatemeh Rajati, Farid Najafi, Samad Ghaffari, Alireza Khosravi, Ahmadreza Assareh and 30 more

Abstract read
In one paragraph

Article in Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

40 authors.

Nizal SarrafzadeganIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Fahimeh BagherikholenjaniIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Shahla ShahidiIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Golsa GhasemiIsfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Ehsan ShirvaniIranian Network of Cardiovascular Research, Tehran, Iran.
Fatemeh RajatiDepartment of Health Education and Health Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Farid NajafiResearch Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Samad GhaffariIranian Network of Cardiovascular Research, Tehran, Iran.
Alireza KhosraviIranian Network of Cardiovascular Research, Tehran, Iran.
Ahmadreza AssarehIranian Network of Cardiovascular Research, Tehran, Iran.
Seyed Mohammad Hassan AdelIranian Network of Cardiovascular Research, Tehran, Iran.
Javad KojuriIranian Network of Cardiovascular Research, Tehran, Iran.
Niloufar SamieiIranian Network of Cardiovascular Research, Tehran, Iran.
Farzad MasoudkabirIranian Network of Cardiovascular Research, Tehran, Iran.
Hossein FarshidiIranian Network of Cardiovascular Research, Tehran, Iran.
Mohammad Kermani-AlghoraishiIranian Network of Cardiovascular Research, Tehran, Iran.
Masoumeh SadeghiIranian Network of Cardiovascular Research, Tehran, Iran.
Davood ShafeiIranian Network of Cardiovascular Research, Tehran, Iran.
Masoumeh JorjaniDepartment of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mansour SiavashIsfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Fariborz KhorvashIsfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Mehdi Nasr IsfahaniDepartment of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Behzad FatemiDepartment of Pharmacoeconomics and Pharmaceutical Administration, Pharmaceutical Management and Economic Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Majid DavariDepartment of Pharmacoeconomics and Pharmaceutical Administration, Pharmaceutical Management and Economic Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Mitra MoradiniaPhysician of Community Health Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Ramesh HoseinkhaniDeputy of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Valiollah HajhashemiDepartment of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
Noushin MohammadifardPediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Majid Ghayour MobarhanIranian UNESCO Center of Excellence for Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
Ali MomeniDepartment of Internal Medicine, School of Medical Science, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Mojgan MortazaviIsfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad AkbariDepartment of Mental Health Nursing, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Fereshteh SattarCardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Fereidoun NoohiIranian Network of Cardiovascular Research, Tehran, Iran.
Maryam KheiriDepartment of Health, Ministry of Health and Medical Education, Tehran, Iran.
Mosa TabatabaeilotfiDepartment of Treatment, Development of Standard and Clinical Practice Guideline Group, Ministry of Health and Medical Education, Tehran, Iran.
Sanaz BakhshandehDepartment of Treatment, Development of Standard and Clinical Practice Guideline Group, Ministry of Health and Medical Education, Tehran, Iran.
Parisa JanjaniCardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Sajad FakhriPharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Alireza AbdiDepartment of Emergency and Critical Care Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: This article introduces the first national guidelines for the management including diagnosis, treatment, and secondary prevention of acute coronary syndrome (ACS) in Iran. Materials and Methods: The members of the guideline development group (GDG) were specialists and experts in fields related to ACS and were affiliated with universities of medical sciences or scientific associations in the country. They carefully examined the evidence and clinical concerns related to ACS management and formulated 13 clinical questions that were sent to systematic review group who developed related evidence using Grade method. Finally the GDG developed the recommendations and suggestions of the guideline. Results: The first three questions in the guideline focus on providing recommendations for handling a patient who experience chest pain at home, in a health house or center, during ambulance transportation, and upon arrival at the emergency department (ED) as well as the initial diagnostic measures in the ED. Subsequently, the recommendations related to the criteria for categorizing patients into low, intermediate and high-risk groups are presented. The guideline addressed primary treatment measures for ACS patients in hospitals with and without code 247 or having primary percutaneous coronary intervention (PCI) facilities, and the appropriate timing for PCI based on the risk assessment. In addition, the most efficacious antiplatelet medications for ACS patients in the ED as well as its optimal duration of treatment are presented. The guideline details the recommendations for therapeutic interventions in patients with ACS and acute heart failure, cardiogenic shock, myocardial infarction with nonobstructive coronary arteries (MINOCA), multivessel occlusion, as well as the indication for prescribing a combined use of anticoagulants and antiplatelet during hospitalization and upon discharge. Regarding secondary prevention, while emphasizing the referral of these patients to rehabilitation centers, other interventions that include pharmaceutical and nonpharmacological ones are addressed, In addition, necessary recommendations for enhancing lifestyle and posthospital discharge pharmaceutical treatments, including their duration, are provided. There are specific recommendations and suggestions for subgroups, such as patients aged over 75 years and individuals with heart failure, diabetes, and chronic kidney disease. Conclusion: Developing guidelines for ACS diagnosis, treatment and secondary prevention according to the local context in Iran can improve the adherence of our health care providers, patients health, and policy makers plans.

Indexed as

Acute coronary syndromeclinical practice guidelinenon-ST-elevation myocardial infarctionST-elevation myocardial infarctionunstable angina

Identifiers

PMID39239072
PMCPMC11376720

What Socratic holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.