Related Experiment Video

Updated: Jan 29, 2026

Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
04:05

Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis

Published on: June 30, 2023

2.8K

Adherence to NSTEMI Guidelines in the Emergency Department: Regression to Reality

Harel Gilutz1, Sevatlana Shindel2, Ilana Shoham-Vardi2

  • 1From the Department of Cardiology, Goldman School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.

Critical Pathways in Cardiology
|February 13, 2019
PubMed

Insights

Adherence to Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) guidelines in the emergency department is low, particularly for timely ECGs and troponin tests. Improved risk stratification and data collection are needed to enhance NSTEMI care.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Health Services Research

Background:

  • Adherence to ST-Segment Elevation Myocardial Infarction guidelines is well-studied, but less is known about emergency department (ED) adherence to Non-ST-Segment Elevation Myocardial Infarction-Acute Coronary Syndrome (NSTEMI-ACS) guidelines.
  • Prompt workup and treatment of NSTEMI-ACS in the ED present ongoing challenges.

Purpose of the Study:

  • To evaluate adherence to established guidelines for the initial management of NSTEMI within the emergency department setting.

Main Methods:

  • A retrospective, single-center study reviewed ED records of 240 NSTEMI patients admitted to a tertiary hospital (March 2013-March 2014).
  • Manual review of records assessed adherence to prespecified parameters, excluding cases of sudden death, shock, or type-II NSTEMI.
  • The Canadian Triage and Acuity Scale was utilized for patient triage.

Main Results:

  • Adherence rates were low: 33.3% for ECG within 10 minutes, 24.6% for troponin within 60 minutes, and 31.3% for anticoagulation within 15 minutes of diagnosis.
  • Females showed lower adherence for ECG and troponin testing within specified timeframes (P=0.009 and P=0.043, respectively).
  • Many cardiovascular risk markers were overlooked, and the Global Registry of Acute Coronary Events score was not used for risk stratification.

Conclusions:

  • There is a significant deficit in prompt identification and early medical treatment of NSTEMI in the ED.
  • Improvements in computerized medical history, recognition of diverse clinical presentations, and consistent use of risk stratification tools are recommended to enhance guideline adherence.
Abstract

More Related Videos

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department07:52

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department

Published on: January 29, 2011

17.0K
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide09:52

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Published on: January 15, 2017

17.9K

Related Concept Videos

Regression Toward the Mean01:52

Regression Toward the Mean

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...
7.0K
Multiple Regression01:25

Multiple Regression

Multiple regression assesses a linear relationship between one response or dependent variable and two or more independent variables. It has many practical applications.
Farmers can use multiple regression to determine the crop yield based on more than one factor, such as water availability, fertilizer, soil properties, etc. Here, the crop yield is the response or dependent variable as it depends on the other independent variables. The analysis requires the construction of a scatter plot...
4.0K
Correlation and Regression00:53

Correlation and Regression

In statistics, correlation describes the degree of association between two variables. In the subfield of linear regression, correlation is mathematically expressed by the correlation coefficient, which describes the strength and direction of the relationship between two variables. The coefficient is symbolically represented by 'r' and ranges from -1 to +1. A positive value indicates a positive correlation where the two variables move in the same direction. A negative value suggests a...
3.4K
Regression Analysis01:11

Regression Analysis

Regression analysis is a statistical tool that describes a mathematical relationship between a dependent variable and one or more independent variables.
In regression analysis, a regression equation is determined based on the line of best fit– a line that best fits the data points plotted in a graph. This line is also called the regression line. The algebraic equation for the regression line is called the regression equation. It is represented as:
8.4K
Emerging Adulthood01:27

Emerging Adulthood

Jeffrey Arnett's concept of emerging adulthood offers a framework to understand the unique developmental stage between adolescence and full-fledged adulthood, generally from ages 18 to 25. This period is marked by extensive exploration and shifts in identity, relationships, and career choices, a process known in psychology as role experimentation. Emerging adulthood reflects the evolving cultural expectations surrounding adulthood and the dynamic process of personal transformation during...
676
Microsoft Excel: Regression Analysis01:18

Microsoft Excel: Regression Analysis

Regression analysis in Microsoft Excel is a powerful statistical method for examining the relationship between a dependent variable and one or more independent variables. It's used extensively in fields such as economics, biology, and business to predict outcomes, understand relationships, and make data-driven decisions. The most common type is linear regression, which attempts to fit a straight line through the data points to model the relationship between variables.
To perform regression...
1.5K