Table 10

Plan of Care for Patients With NSTE-ACS

Plan of CareResources/References
Medications
Antithrombotic therapies
  • Sections 6.2.1 and 6.2.2

Beta blockers
  • Section 4.1.2.3

ACE inhibitors/ARBs/aldosterone antagonists
  • Section 4.2

CCBs
  • Section 4.1.2.4

Statins
  • 2013 Blood cholesterol CPG (18)

Discontinuation of antithrombotic therapies for elective surgical and medical procedures with increased risk of bleeding
  • 2014 SIHD focused update (10)

  • 2012 SIHD CPG (11)

  • 2012 Management of AMI in patients with persistent STEMI CPG (19)

  • 2011 Secondary prevention CPG (27)

  • 2007 Science Advisory on the prevention of premature discontinuation of DAPT in patients with coronary artery stents (504)

Inappropriate use of analgesics (NSAIDs)
  • 2010 Expert consensus document on PPIs and thienopyridines (430)

Use of PPIs
  • 2011 PCI CPG (26)

Risk factor modification/lifestyle interventions and physical activity/cardiac rehabilitation
Smoking cessation
  • Tobacco cessation toolkit (505)

Diet nutrition
  • 2013 Lifestyle CPG (15)

Physical activity
  • 2013 Lifestyle CPG (15)

  • 2011 Secondary prevention CPG (27)

Cardiorespiratory fitness (MET capacity)
  • 2011 Secondary prevention CPG (27)

  • 2010 Performance measures on cardiac rehabilitation (454)

  • 2012 Scientific statement on sexual activity and cardiovascular disease (231)

Management of comorbidities
Overweight/obesity
  • 2013 Obesity CPG (16)

  • 2011 Secondary prevention CPG (27)

Statins
  • 2013 Lifestyle CPG (15)

  • 2013 Blood cholesterol CPG (18)

Hypertension
  • 2014 Report on high BP (501)

  • 2013 Science advisory on high BP control (506)

Diabetes mellitus
  • 2013 Position statement on standards of medical care in diabetes (507)

HF
  • 2013 HF CPG (14)

Arrhythmia/Arrhythmia risk
  • 2012 Focused update incorporated into the 2008 DBT CPG (20)

  • 2014 AF CPG (12)

Psychosocial factors
Sexual activity
  • 2012 Scientific statement on sexual activity and cardiovascular disease (231)

  • 2013 Consensus document on sexual counseling for individuals with cardiovascular disease and their partners (508)

Gender-Specific issues
  • 2007 Cardiovascular disease prevention in women CPG (475)

Depression, stress, and anxiety
  • 2008 Science advisory on depression and coronary heart disease (509)

Alcohol use
  • 2011 Secondary prevention CPG (27)

Culturally sensitive issues
  • 2009 Consensus report on a comprehensive framework and preferred practices for measuring and reporting cultural competency (510)

Return to work schedule
Clinician follow-up
Cardiologist
  • 2011 Secondary prevention CPG (27)

  • 2013 Hospital to Home Quality Initiative (511)

Primary care clinician
Advanced practice nurse/physician assistant
Pharmacists
  • 2013 Discharge counseling for patients with HF or MI (512)

Other relevant medical specialists
Electronic personal health records
Influenza vaccination
  • 2005 Recommendations for prevention and control of influenza (37)

Patient/family education
Plan of care for AMI
  • 2010 CPG for cardiopulmonary resuscitation and emergency cardiovascular care—part 9: postcardiac arrest care (31)

  • 2013 STEMI CPG (17)

Recognizing symptoms of MI
Activating EMS, signs and symptoms for urgent vs. emergency evaluations
CPR training for family members
Risk assessment and prognosis
Advanced directives
Social networks/social isolation
Socioeconomic factors
Access to health insurance coverage
Access to clinicians
  • Effective communication and care coordination (513)

Disability
  • Cardiovascular disability: updating Social Security listings (514)

Social services
Community services

ACE indicates angiotensin-converting enzyme; AF, atrial fibrillation; AMI, acute myocardial infarction; ARB, angiotensin receptor blocker; BP, blood pressure; CCB, calcium channel blocker; CPG, clinical practice guideline; CPR, cardiopulmonary resuscitation; DAPT, dual antiplatelet therapy; DBT, device-based therapy; ECC, emergency cardiovascular care; EMS, emergency medical services; HF, heart failure; MET, metabolic equivalent; MI, myocardial infarction; NSAID, nonsteroidal anti-inflammatory drug; NSTE-ACS, non–ST-elevation acute coronary syndromes; PCI, percutaneous coronary intervention; PPI, protein pump inhibitor; SIHD, stable ischemic heart disease; and STEMI, ST-elevation myocardial infarction.