Table 2.

Criteria for adjudication of UA hospitalization defined by the Standardized Data Collection for Cardiovascular Trials Initiative and the US Food and Drug Administration [30] Criteria for adjudication of hospitalization for UA

UA requiring hospitalization is defined as

1. Ischemic discomfort (angina, or symptoms thought to be equivalent) ≥10 min in duration occurring at rest or in an accelerating pattern with frequent episodes associated with progressively decreased exercise capacity.

AND

2. Prompting an unscheduled hospitalization within 24 hours of the most recent symptoms. Hospitalization is defined as an admission to an inpatient unit or a visit to an emergency department that results in at least a 24-hours stay (or a change in calendar date if the hospital admission or discharge times are not available).

AND

3. At least one of the following: a. New or worsening ST- or T-wave changes on resting ECG (in the absence of confounders, such as LBBB or LVH)

Transient ST-elevation (duration <20 minutes)

New ST-elevation at the J-point in two contiguous leads with the cut-points:

≥0.1 mV in all leads other than leads V2–V3 where the following cut-points apply:

≥0.2 mV in men ≥40 years (≥0.25 mV in men <40 years) or ≥0.15 mV in women.

ST-depression and T-wave changes

New horizontal or down-sloping ST depression ≥0.05 mV in two contiguous leads and/or new T-wave inversion ≥0.3 mV in two contiguous leads with prominent R-wave or R/S-ratio >1.

b. Definite evidence of inducible myocardial ischemia as demonstrated by: An early positive exercise stress test, defined as ST-elevation or ≥2 mm ST-depression prior to 5 METs

OR

Stress echocardiography (reversible wall motion abnormality) OR

Myocardial scintigraphy (reversible perfusion defect), OR

MRI (myocardial perfusion deficit under pharmacologic stress). and believed to be responsible for the myocardial ischemic symptoms/signs.

c. Angiographic evidence of new or worse ≥70% lesion (≥50% for left main lesion) and/or thrombus in an epicardial coronary artery that is believed to be responsible for the myocardial ischemic symptoms/signs.

d. Need for coronary revascularization procedure (PCI or CABG) for the presumed culprit lesion(s), as defined in 3c. This criterion would be fulfilled if revascularization was undertaken during the unscheduled hospitalization, or subsequent to transfer to another institution without interceding home discharge.

AND

4. Negative cardiac biomarkers and no evidence of acute MI

CABG, coronary artery bypass grafting; LBBB, left bundle branch block; LVH, left ventricular hypertrophy; METs, metabolic equivalents; MI, myocardial infarction; MRI, magnetic resonance imaging; PCI, percutaneous coronary intervention.