Translation of acute coronary syndrome therapies: from evidence to routine clinical practice.

Background: The use of evidence-based therapies has improved the outcome of patients with acute coronary syndrome (ACS), but there is a time lag between the generation of clinical evidence and its application in routine clinical practice. We sought to quantify temporal lags in the lifecycle of American College of Cardiology (ACC)/American Heart Association (AHA) class IA ACS therapies.

Methods: Using current and historical ACC/AHA guideline publications, we retrieved publication dates of pivotal clinical trials (PCTs) and class IA guideline-recommended therapies for patients with ST-elevation myocardial infarction (STEMI) and unstable angina (UA)/non-STEMI (NSTEMI).

The need for transformative innovation in hypertension management.

Despite multiple available effective therapies for hypertension, many patients with high blood pressure in the United States are not adequately controlled. This inability to effectively manage hypertension can be attributed to patient, provider, and system failures. To create an effective model for hypertension management, current care delivery systems must be reorganized around the following principles: improved patient engagement and patient-provider communication, increased use of nonphysician providers, better performance monitoring and feedback systems, and better aligned reimbursement models.