{"id":"3dc19c1410ed","type":"article","url":"https://hartvaat.nl/2017/02/07/acc-aats-aha-2016-criteria-voor-gepaste-coronaire-revascularisatie-bij-acs-en-st/","title":"ACC/AATS/AHA 2016 criteria voor gepaste coronaire revascularisatie bij ACS en stabiel coronairlijden","title_en":"ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society of Thoracic Surgeons.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-coronair-syndroom"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2016.10.034","source_url":"https://doi.org/10.1016/j.jacc.2016.10.034","authors":["Manesh R Patel","John H Calhoon","Gregory J Dehmer","James Aaron Grantham","Thomas M Maddox","David J Maron","Peter K Smith"],"significance":8,"published":"2017-02-07","source_date":"2017-02-07","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/pci-percutane-coronaire-interventie/","https://hartvaat.nl/kennis/coronairlijden/cabg-bypasschirurgie/"],"congress":"","summary_en":"These updated appropriate use criteria for coronary revascularization provided consensus recommendations on the appropriateness of PCI and CABG across various clinical scenarios in both acute coronary syndromes and stable ischemic heart disease.","created":"2026-07-03T10:26:33Z","updated":"2026-07-03T13:25:52Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Appropriate use criteria voor coronaire revascularisatie met geüpdatete aanbevelingen voor PCI en CABG bij zowel ACS als stabiel coronairlijden. Standaardwerk voor indicatiestelling.","abstract_original":"The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision of the appropriate use criteria (AUC) for coronary revascularization. In prior coronary revascularization AUC documents, indications for revascularization in acute coronary syndromes (ACS) and stable ischemic heart disease were combined into 1 document. To address the expanding clinical indications for coronary revascularization, and in an effort to align the subject matter with the most current American College of Cardiology/American Heart Association guidelines, the new AUC for coronary artery revascularization were separated into 2 documents addressing ACS and stable ischemic heart disease individually. This document presents the AUC for ACS. Clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, presence of clinical instability or ongoing ischemic symptoms, prior reperfusion therapy, risk level as assessed by noninvasive testing, fractional flow reserve testing, and coronary anatomy. This update provides a reassessment of clinical scenarios that the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document but employs the recent modifications in the methods for developing AUC, most notably, alterations in the nomenclature for appropriate use categorization. A separate, independent rating panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate for the clinical scenario presented. Scores of 1 to 3 indicate that revascularization is considered rarely appropriate for the clinical scenario, whereas scores in the mid-range (4 to 6) indicate that coronary revascularization may be appropriate for the clinical scenario. Seventeen clinical scenarios were developed by a writing committee and scored by the rating panel: 10 were identified as appropriate, 6 as may be appropriate, and 1 as rarely appropriate. As seen with the prior coronary revascularization AUC, revascularization in clinical scenarios with ST-segment elevation myocardial infarction and non–ST-segment elevation myocardial infarction were considered appropriate. Likewise, clinical scenarios with unstable angina and intermediate- or high-risk features were deemed appropriate. Additionally, the management of nonculprit artery disease and the timing of revascularization are now also rated. The primary objective of the AUC is to provide a framework for the assessment of practice patterns that will hopefully improve physician decision making."}