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Acute Coronary SyndromesBest practice, Best evidence

A/Prof David BriegerChair, NHF ACS Guideline Implementation and

Advocacy Working group

NHFA held a Stakeholder Forum in 2003: Co-sponsored by NHFA and CSANZ

• Entitled: “Reducing time-to-care for patients with AMI”• Previously, two guidelines relating to ACS:

– NHFA/CSANZ Management of unstable angina – 2000– NHFA Reperfusion therapy for acute myocardial infarction - 2002

• 2003 Forum involved specialists and representatives from key organisations, including:

Royal Australasian College of PhysiciansInternal Medicine Society of Australia and New ZealandNational Aboriginal Community Controlled Health OrganisationNational Institute of Clinical StudiesAustralian Resuscitation CouncilRoyal College of Nursing

Australasian College of Emergency MedicineAustralian College of Rural and Remote MedicineDepartment of Health and AgeingAustralian Cardiac Rehabilitation AssociationRoyal Australian College of General Practitioners

2003 Forum (cont.)

• Aimed to inform work in:Reducing patient delay in response to symptoms of AMIBest practice care for the management of acute coronary syndromes (ACS)

2003 Forum (cont.)Key outcomes:1. Establishment of Chest Pain Working

Group:‘Chest pain’ identified as a Heart Foundation priority project.Revision of key messages regarding warning signs of heart attack and recommendations for action.Culminated in ‘Early Warning program’

2. Update and integration of existing guidelines into NHFA/CSANZ Guidelines for the management of acute coronary syndromes 2006 (published in April 2006)

3. Develop an ‘ACS implementation plan’ to improve the adoption of these guidelines into clinical practice around Australia

TODAYProvide an outline of the Guidelines:

Best practice based on best evidenceUpdate on progress of the implementation program

ST elevation myocardial infarction

2007 National Acute Coronary Syndrome Implementation Forum

Key objective: • To advise the Heart Foundation about the

priority interventions that will improve the management of ACS in Australia

FORUM: Recommendations