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What's New ACCF/AHA Guidelines?

Each year, the American College of Cardiology Foundation (ACCF) introduces new and/or updated Clinical Practice Guidelines that represent the most current evidence-based medicine. Selected recommendations from two Practice Guidelines follow.
Jonathan L. Halperin, MD, Mt. Sinai Medical Center, New York, New York, USA, and Thomas Brott, MD, Mayo Clinic, Jacksonville, Florida, USA, jointly presented some of the key guidelines from the 2011 Guideline on the Management of Patients with Extracranial Carotid and Vertebral Artery Disease (ECVD).

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Are There Differences Between ACC/AHA and ESC STEMI Guidelines?

Robert P. Giugliano, MD, Brigham & Women's Hospital, Boston, Massachusetts, USA, discussed the similarities and differences between the ACC/American Heart Association (ACC/AHA) and European Society of Cardiology (ESC) Guidelines.
"Overall," said Dr. Giugliano, "the guidelines for patients with STEMI published by the ACC/AHA and the ESC are similar in terms of approach (ie, structure, rigor, and classification and level of evidence), the types of guidelines (eg, both full and focused updates), and the versions that are offered (eg, pocket, web, etc). The differences lie primarily in the areas of style, scope/timing, attitude, and belief."

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Is it Time for Personalized Medicine?

Since its approval in 1997, clopidogrel has been a cornerstone of therapy in patients with acute coronary syndrome (ACS) and in those patients who are undergoing percutaneous coronary intervention (PCI). Although the drug reduces the risk of future ischemic events, high variability in the antiplatelet effect between patients has been demonstrated. A number of factors are responsible for this variability, including clinical factors, drug interactions, and the presence of CYP2C19 loss-of-function alleles that hinder the metabolism of clopidogrel to its active form, thus leading to attenuation of its antiplatelet effect [Brandt JT et al. J Thromb Haemost 2007].

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