ACC, AHA work to standardize the way cardiologists and their colleagues talk about chest pain
The American College of Cardiology (ACC) and American Heart Association (AHA) have collaborated on new guidelines designed to standardize the terms and definitions cardiologists, cardiac surgeons and other healthcare providers use when discussing the diagnosis and treatment of chest pain. The document is an update to the much-discussed chest pain guidelines the ACC and AHA published in October 2021.[1]
“Clinical data standards aim to identify, define, and standardize data elements relevant to clinical topics in cardiovascular medicine, with the primary goal of assisting data collection and use by providing a compilation of data elements and definitions applicable to various cardiovascular conditions.,” according to the new guideline. “Broad agreement on common vocabulary and definitions is needed to pool and compare data from electronic health records, clinical registries, administrative datasets, and other databases and to assess whether these data are applicable to clinical practice and research endeavors.”
While chest pain symptoms have traditionally been described as “typical” or “atypical,” the new guidelines said the categories should now be “cardiac,” “possible cardiac” and “noncardiac.” In addition, the new document provides updated data elements for procedure-related myocardial injury and procedure-related myocardial infarction.
The groups also noted that chest pain will remain a crucial topics for researchers and clinicians alike in the years ahead.
“The diagnosis and management of chest pain will remain a fertile area of investigation, with randomized evaluations complementing insights provided by registries of patients presenting with chest pain,” according to the guideline. “In the future, registries will more frequently serve as platforms within which to conduct randomized trials. Accreditation activities coupled with registry participation will also need to be evaluated to determine if they not only improve processes of care, but also affect clinical endpoints. Assessment of long-term outcomes, patient-centered metrics and cost will be integrated into these studies to enhance the evidence base for care of patients presenting with chest pain with greater precision.”
The American College of Emergency Physicians and Society for Cardiac Angiography and Interventions also contributed to the new document. The Society for Academic Emergency Medicine did not directly contribute to the document, but they have endorsed it.
The guidelines were simultaneously published in full in the Journal of the American College of Cardiology and Circulation: Cardiovascular Quality and Outcomes.[2, 3]