Table 1.
Durability of 619 Class I Recommendations Abstracted From 11 ACC/AHA Guidelines Across 2 Guideline Versions
| Index Guideline | Status of Recommendation in Revised (Current) Guidelinea | |||||
|---|---|---|---|---|---|---|
| Guideline Topic | Year | Class I Recommendations, No. |
Year | Retained, No. (%) |
Downgraded or Reversed, No. (%) |
Omitted, No. (%) |
| Atrial fibrillation | 200118 | 46 | 200619 | 38 (82.6) | 7 (15.2) | 1 (2.2) |
| Preoperative cardiovascular evaluation | 200220 | 13 | 200721 | 2 (15.4) | 2 (15.4) | 9 (69.2) |
| Pacemakers and implantable rhythm-management devices | 200223 | 34 | 200822 | 32 (94.1) | 1 (2.9) | 1 (2.9) |
| Chronic stable angina | 200234 | 79 | 201233 | 59 (74.7) | 10 (12.7) | 10 (12.7) |
| Secondary prevention of ischemic heart disease | 200624 | 38 | 201125 | 35 (92.1) | 3 (7.9) | 0 |
| Coronary artery bypass graft procedures | 200416 | 39 | 201126 | 32 (82.1) | 4 (10.3) | 3 (7.7) |
| Percutaneous coronary intervention | 200532 | 41 | 201131 | 36 (87.8) | 4 (9.8) | 1 (2.4) |
| Management of coronary artery disease in women | 200727 | 24 | 201128 | 20 (79.2) | 3 (12.5) | 1 (4.2) |
| Unstable angina/non–ST-segment elevation myocardial infarction | 200236 | 83 | 200735 | 75 (90.4) | 6 (7.2) | 2 (2.4) |
| Congestive heart failure | 200529 | 66 | 201330 | 36 (54.6) | 5 (7.6) | 25 (37.9) |
| Valvular heart disease | 199837 | 156 | 200638 | 130 (86.3) | 12 (7.7) | 14 (9.0) |
| All topics | 619 | 495 (80.0) | 57 (9.2) | 67 (10.8) | ||
Abbreviations: ACC/AHA, American College of Cardiology/American Heart Association.
a
P < .001 for difference in percentages retained, downgraded/reversed, or omitted across guidelines.