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Non-ST Elevation ACS Discharge Checklist

Non-ST Elevation ACS Discharge Checklist - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Clinical Practice Guidelines, Cardiovascular, Related

Non-ST Elevation Acute Coronary Syndromes
Discharge Check List
Note: This checklist does not replace individual clinical judgement and/or consideration for patient tolerance of
specific medications or therapies.
 Aspirin 81 mg daily. (AHA Class I, LOE A)
 Clopidogrel 75 mg daily for 12 months post NSTE-ACS (with no interruption if drug covered stent
was placed). (AHA Class I, LOE B)
 Sublingual nitroglycerin PRN. (AHA Class I, LOE C)
 Proton pump inhibitor if history of GI bleeding and/or requires triple therapy with vitamin K
antagonists, aspirin, and p2Y12 receptor inhibitor. (AHA Class I, LOE C)
 Beta blockers (AHA Class I, LOE A)
 ACE inhibitors (or ARBs if ACE-I intolerant): EF < 40%, HTN, DM, stable CKD. (AHA Class I, LOE A)
 Aldosterone blockage (spirlactone 25 mg daily of eplereone 50 mg daily) if EF < 40%, DM, or HF
(provided creatinine < 2.5 mg/dL for men and < 2.0 mg/dL for women and potassium is less than 5
mEq/L. (AHA Class I, LOE A)
 High Dose Statin – atorvastatin 80 mg daily. (AHA Class I, LOE A)
 Cardiac Rehab Consult (AHA Class I, LOE B)
 Pneumococcal Vaccine (AHA Class I, LOE B)
 Annual influenza Vaccine (AHA Class I, LOE C)
 Avoid NSAIDs (AHA Class III, LOE B)
 Follow-up with patient (AHA Class I, LOE B)
ξ UW Health recommends in 1-2 weeks with PCP and 4-6 weeks with Cardiology
 Patient Education (AHA Class I, LOE C) to include:
ξ Warning symptoms
ξ When to seek emergency care.
ξ Medication education.
ξ CV risk Factor modification.
ξ Smoking Cessation
Last revised/reviewed: 04/2015 | Contact CCKM for revisions.
UW Health Non-ST-Elevation Acute Coronary Syndromes – Adult – Inpatient/Ambulatory CPG
Reference: Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC Guideline for the Management of Patients With
Non-ST-Elevation Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart
Association Task Force on Practice Guidelines. Circulation. 2014;130(25):e344-426.
Copyright © 2015 Univ ersity of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 04/2015CCKM@uwhealth.org