Outcome measurement: evaluating evidence for managing patients with acute coronary syndromes

Evidence-based practice has been proposed as a means to improve the quality of care and decrease unwarranted variability in practice, but evaluating clinical trial data as evidence for practice is made more difficult because practice changes rapidly. This article reviews current clinical trial data on the management of patients with acute coronary syndromes, but the same principles can be used when evaluating alternative medicines. Current evidence supports risk stratification, early treatment with glycoprotein IIb/IIIa inhibitors, and an early invasive strategy in patients who are at intermediate to high risk. In addition, cholesterol-lowering statins should be initiated early in the patient's hospitalization.