TY - JOUR
T1 - Comparison of the American College of Cardiology/American Heart Association and the European Society of Cardiology Guidelines for the Management of Patients with Valvular Heart Disease
AU - Alame, Aya J.
AU - Karatasakis, Aris
AU - Karacsonyi, Judit
AU - Danek, Barbara A.
AU - Sorajja, Paul
AU - Gössl, Mario
AU - Garcia, Santiago
AU - Jneid, Hani
AU - Kakouros, Nikolaos
AU - Martinez-Parachini, Jose Roberto
AU - Resendes, Erica
AU - Kalsaria, Pratik
AU - Roesle, Michele
AU - Rangan, Bavana V.
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
PY - 2017/9
Y1 - 2017/9
N2 - BACKGROUND: The American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) have developed guidelines to assist clinicians in making evidence-based decisions. This study compares the ACC/AHA and ESC guidelines for the management of patients with valvular heart disease (VHD). METHODS: The current ACC/AHA and ESC guidelines for VHD, last updated in 2014 and 2012, respectively, were compared by class of recommendation (COR), level of evidence (LOE), and content. RESULTS: The ACC/AHA and ESC VHD guidelines contain 229 and 85 recommendations, respectively. The COR distributions of the ACC/AHA and ESC VHD guidelines were 47.6% vs 44.7% class I [P≤.65]; 46.3% vs 55.3% class II [P≤.16]; and 6.1% vs 0.0% class III [P≤.01], respectively. The LOE distributions were 3.1% vs 0.0% LOE A [P≤.20]; 47.2% vs 10.6% LOE B [P<.001]; and 49.8% vs 89.4% LOE C [P<.001], respectively. The recommendation type distributions were 31.0% vs 2.4% diagnostic [P<.001]; 23.1% vs 16.5% medical therapy [P≤.20]; and 45.9% vs 81.2% interventional/surgical recommendations [P<.001], respectively. The content of the guidelines was similar, with only minor differences in a few recommendations. CONCLUSIONS: The ACC/AHA VHD guidelines contain significantly more recommendations. The distribution of COR was similar, but the ACC/AHA guidelines included more LOE B recommendations and fewer LOE C recommendations, suggesting that the ACC/AHA guidelines place greater emphasis on published data than expert opinion. Overall, the ACC/AHA and ESC guidelines provide similar recommendations, suggesting consistency in practice; however, the relative paucity of LOE A recommendations highlights the need for additional research.
AB - BACKGROUND: The American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) have developed guidelines to assist clinicians in making evidence-based decisions. This study compares the ACC/AHA and ESC guidelines for the management of patients with valvular heart disease (VHD). METHODS: The current ACC/AHA and ESC guidelines for VHD, last updated in 2014 and 2012, respectively, were compared by class of recommendation (COR), level of evidence (LOE), and content. RESULTS: The ACC/AHA and ESC VHD guidelines contain 229 and 85 recommendations, respectively. The COR distributions of the ACC/AHA and ESC VHD guidelines were 47.6% vs 44.7% class I [P≤.65]; 46.3% vs 55.3% class II [P≤.16]; and 6.1% vs 0.0% class III [P≤.01], respectively. The LOE distributions were 3.1% vs 0.0% LOE A [P≤.20]; 47.2% vs 10.6% LOE B [P<.001]; and 49.8% vs 89.4% LOE C [P<.001], respectively. The recommendation type distributions were 31.0% vs 2.4% diagnostic [P<.001]; 23.1% vs 16.5% medical therapy [P≤.20]; and 45.9% vs 81.2% interventional/surgical recommendations [P<.001], respectively. The content of the guidelines was similar, with only minor differences in a few recommendations. CONCLUSIONS: The ACC/AHA VHD guidelines contain significantly more recommendations. The distribution of COR was similar, but the ACC/AHA guidelines included more LOE B recommendations and fewer LOE C recommendations, suggesting that the ACC/AHA guidelines place greater emphasis on published data than expert opinion. Overall, the ACC/AHA and ESC guidelines provide similar recommendations, suggesting consistency in practice; however, the relative paucity of LOE A recommendations highlights the need for additional research.
KW - guidelines
KW - outcomes
KW - quality
KW - valvular heart disease
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M3 - Article
C2 - 28420803
AN - SCOPUS:85032638892
SN - 1042-3931
VL - 29
SP - 320
EP - 326
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 9
ER -