2026-04-30T03:51:09Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/237952024-11-28T20:45:57Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967

00925njm 22002777a 4500 dc González-Del-Hoyo, Maribel author Mas-Lladó, Caterina author Blaya-Peña, Laura author Siquier-Padilla, Joan author Coughlan, J J author Peral, Vicente author Rosselló, Xavier author 2023-07-12 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. Gonzalez-Del-Hoyo M, Mas-Llado C, Blaya-Peña L, Siquier-Padilla J, Coughlan JJ, Peral V, et al. Type of evidence supporting ACC/AHA and ESC clinical practice guidelines for acute coronary syndrome. Clin Res Cardiol. 2023 Jul 12. 10.1007/s00392-023-02262-9 1861-0692 Clinical research in cardiology : official journal of the German Cardiac Society https://hdl.handle.net/20.500.13003/19372 37436514 L2024382643 2-s2.0-85164485073 https://hdl.handle.net/20.500.12105/23795 1028480600001 Type of evidence supporting ACC/AHA and ESC clinical practice guidelines for acute coronary syndrome