Title of Guidelines
|
Year
|
Class III Recommendation
|
Level of Evidence
|
Effect
|
Key Word
|
ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery |
2014 |
Routine use of pulmonary artery catheterization in patients, even those with elevated risk, is not recommended. |
A |
No Benefit |
Cardiac evaluation for non cardiac surgery
|
ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery |
2009 |
Routine use of a PAC perioperatively, especially in patients at low risk of developing hemodynamic disturbances, is not recommended. |
A |
N/A |
Perioperative Beta Blockade
|
ACCF/AHA Guideline for the Management of Heart Failure |
2013 |
Statins are not beneficial as adjunctive therapy when prescribed solely for the diagnosis of HF in the absence of other indications for their use. |
A |
No Benefit |
Heart failure
|
ACCF/AHA Guideline for the Management of Heart Failure |
2013 |
Calcium channel–blocking drugs are not recommended as routine treatment for patients with HFrEF |
A |
No Benefit |
Heart failure
|
ACCF/AHA Guideline for the Management of Heart Failure |
2013 |
Statins are not beneficial as adjunctive therapy when prescribed solely for the diagnosis of HF in the absence of other indications for their use. |
A |
No Benefit |
Heart failure
|
ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease |
2012 |
Estrogen therapy is not recommended in postmenopausal women with SIHD with the intent of reducing cardiovascular risk or improving clinical outcomes. |
A |
No Benefit |
Ischemic heart disease
|
ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease |
2012 |
Treatment of elevated homocysteine with folate or vitamins B6 and B12 is not recommended with the intent of reducing cardiovascular risk or improving clinical outcomes in patients with SIHD. |
A |
No Benefit |
Ischemic heart disease
|
ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease |
2012 |
Vitamin C, vitamin E, and beta-carotene supplementation are not recommended with the intent of reducing cardiovascular risk or improving clinical outcomes in patients with SIHD. |
A |
No Benefit |
Ischemic heart disease
|
ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention |
2011 |
Administration of N-acetyl-L-cysteine is not useful for the prevention of contrast-induced acute kidney injury. |
A |
No Benefit |
PCI
|
ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention |
2011 |
Cutting balloon angioplasty should not be performed routinely during PCI. |
A |
No Benefit |
PCI
|
ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention |
2011 |
Laser angioplasty should not be used routinely during PCI. |
A |
No Benefit |
PCI
|
ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention |
2011 |
Rotational atherectomy should not be performed routinely for de novo lesions or in-stent restenosis. |
A |
No Benefit |
PCI
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
Antioxidant vitamin supplements (eg, vitamins E, C, or beta carotene) should not be used for secondary prevention in patients with NSTE-ACS. |
A |
No Benefit |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
Folic acid, with or without vitamins B6 and B12, should not be used for secondary prevention in patients with NSTE-ACS. |
A |
No Benefit |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
Hormone therapy with estrogen plus progestin, or estrogen alone, should not be given as new drugs for secondary prevention of coronary events to postmenopausal women after NSTE-ACS and should not be continued in previous users unless the benefits outweigh the estimated risks. |
A |
Harm |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
In patients with NSTE-ACS (ie, without ST-elevation, true posterior Ml, or left bundle-branch block not known to be old), intravenous fibrinolytic therapy should not be used. |
A |
Harm |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
With contemporary troponin assays, creatine kinase myocardial isoenzyme (CK-MB) and myoglobin are not useful for diagnosis of ACS. |
A |
No Benefit |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease |
2014 |
Statin therapy is not indicated for prevention of hemodynamic progression of AS in patients with mild-to-moderate calcific valve disease (stages B to D). |
A |
No Benefit |
Valvular heart disease
|
AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science |
2010 |
Management of Arrhythmias,Ventricular Rhythm Disturbances Prophylactic administration of lidocaine is not recommended |
A |
N/A |
Cardiopulmonary Resuscitation
|
AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science |
2010 |
Management of Arrhythmias,Ventricular Rhythm Disturbances Pprophylactic antiarrhythmics are not recommended for patients with suspected ACS or myocardial infarction in the prehospital or ED |
A |
N/A |
Cardiopulmonary Resuscitation
|
AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science |
2010 |
Cardiac Arrest Associated With Pulmonary Embolism In patients with cardiac arrest and without known PE, routine fibrinolytic treatment given during CPR shows no benefit185,186 and is not recommended |
A |
N/A |
Cardiopulmonary Resuscitation
|
AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science |
2010 |
Other Vasopressors,Magnesium Sulfate Routine administration of magnesium sulfate in cardiac arrest is not recommended unless torsades de pointes is present. |
A |
N/A |
Cardiopulmonary Resuscitation
|
ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease |
2008 |
Pregnancy in patients with ASD and severe PAH (Eisenmenger syndrome) is not recommended owing to excessive maternal and fetal mortality and should be strongly discouraged. |
A |
N/A |
Congenital heart disease
|
ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease |
2008 |
Pregnancy in patients with VSD and severe PAH (Eisenmenger syndrome) is not recommended owing to excessive maternal and fetal mortality and should be strongly discouraged. |
A |
N/A |
Congenital heart disease
|
ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery |
2014 |
Routine use of pulmonary artery catheterization in patients, even those with elevated risk, is not recommended. |
A |
No Benefit |
Cardiac risk evaluation for non-cardiac surgery
|
ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults |
2013 |
CK should not be routinely measured in individuals receiving statin therapy. |
A |
No benefit |
Dyslipidemia
|
ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults |
2013 |
It may be harmful to initiate simvastatin at 80 mg daily or increase the dose of simvastatin to 80 mg daily. |
A |
Harm |
Dyslipidemia
|
ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) |
2005 |
Chelation (e.g., ethylenediaminetetraacetic acid) is not indicated for treatment of intermittent claudication and may have harmful adverse effects. |
A |
N/A |
Peripheral arterial disease
|
ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) |
2005 |
Intervention is not recommended for asymptomatic infrarenal or juxtarenal AAAs if they measure less than 5.0 cm in diameter in men or less than 4.5 cm in diameter in women. |
A |
N/A |
Peripheral arterial disease
|
ACC/AHA Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) |
2005 |
Oral vasodilator prostaglandins such as beraprost and iloprost are not effective medications to improve walking distance in patients with intermittent claudication. |
A |
N/A |
Peripheral arterial disease
|
ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death |
2006 |
Class IC antiarrhythmic drugs in patients with a past history of MI should not be used. |
A |
No Benefit |
Ventricular arrhythmias
|
ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities |
2008 |
Permanent pacing is not indicated for torsade de pointes VT due to reversible causes. |
A |
N/A |
Device-based therapy
|
ACCF/AHA Guideline for the Management of Heart Failure |
2013 |
Calcium channel–blocking drugs are not recommended as routine treatment for patients with HFrEF. |
A |
No Benefit |
Heart Failure
|
ACCF/AHA Guideline for the Management of Heart Failure |
2013 |
Statins are not beneficial as adjunctive therapy when prescribed solely for the diagnosis of HF in the absence of other indications for their use |
A |
No Benefit |
Heart Failure
|
ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease |
2012 |
Vitamin C, vitamin E, and beta-carotene supplementation are not recommended with the intent of reducing cardiovascular risk or improving clinical outcomes in patients with SIHD |
A |
No Benefit |
Stable ischemic heart disease
|
ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities |
|
Permanent pacing is not indicated for torsade de pointes VT due to reversible causes. |
A |
N/A |
Cardiac Rhythm Abnormalities
|
AHA Scientific Statement: Secondary Prevention After Coronary Artery Bypass Graft Surgery |
2015 |
Among patients with LV dysfunction (EF <35%), ICD therapy is not recommended for the prevention of sudden cardiac death after CABG until 3 months of postoperative goal-directed medical therapy has been provided and persistent LV dysfunction has been confirmed |
A |
N/A |
CABG
|
AHA Scientific Statement: Secondary Prevention After Coronary Artery Bypass Graft Surgery |
2015 |
Warfarin should not be routinely prescribed after CABG for graft patency unless patients have other indications for long-term antithrombotic therapy (such as AF, venous thromboembolism, or a mechanical prosthetic valve) |
A |
N/A |
CABG
|
AHA Scientific Statement: Diagnosis and Treatment of Fetal Cardiac Disease |
2014 |
Fetal medical therapy is of no benefit for fetuses with sinus bradycardia, irregular rhythms caused by extrasystolic beats. |
A |
N/A |
Fetal cardiac disease
|
AHA Scientific Statement: Diagnosis and Treatment of Fetal Cardiac Disease |
2014 |
Referral for fetal cardiac evaluation is not indicated for maternal medications including SSRIs (other than paroxetine). |
A |
N/A |
Fetal cardiac disease
|
AHA Scientific Statement: Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension |
2011 |
Systemic fibrinolysis should not be given routinely to patients with IFDVT. |
A |
N/A |
Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension
|
AHA Scientific Statement: The Postthrombotic Syndrome Evidence-Based Prevention, Diagnosis, and Treatment Strategies |
2014 |
Recommendations for Thrombolysis and Endovascular Approaches to Acute DVT for the Prevention of PTS Systemic thrombolysis is not recommended for the treatment of DVT |
A |
N/A |
Postthrombotic Syndrome
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
Antioxidant vitamin supplements (eg, vitamins E, C, or beta carotene) should not be used for secondary prevention in patients with NSTE-ACS. |
A |
No Benefit |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
Folic acid, with or without vitamins B6 and B12, should not be used for secondary prevention in patients with NSTE-ACS. |
A |
No Benefit |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
Hormone therapy with estrogen plus progestin, or estrogen alone, should not be given as new drugs for secondary prevention of coronary events to postmenopausal women after NSTE-ACS and should not be continued in previous users unless the benefits outweigh the estimated risks. |
A |
Harm |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
In patients with NSTE-ACS (ie, without ST-elevation, true posterior MI, or left bundle-branch block not known to be old), intravenous fibrinolytic therapy should not be used. |
A |
Harm |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes |
2014 |
With contemporary troponin assays, creatine kinase myocardial isoenzyme (CK-MB) and myoglobin are not useful for diagnosis of ACS. |
A |
No Benefit |
NSTEMI
|
AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease |
2014 |
Statin therapy is not indicated for prevention of hemodynamic progression of AS in patients with mild-to-moderate calcific valve disease (stages B to D). |
A |
No Benefit |
Valvular heart disease
|
AHA Scientific Statement: Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates |
2012 |
Initiating beta-blocker therapy in beta-blocker–naïve patients the night before and/or the morning of noncardiac surgery is not recommended |
A |
N/A |
Kidney and Liver Transplantation Candidates
|
Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease |
2011 |
Except in extraordinary circumstances, carotid revascularization by either CEA or CAS is not recommended when atherosclerosis narrows the lumen by less than 50%. |
A |
No Benefit |
Extracranial Carotid and Vertebral Artery Disease
|
AHA/ASA Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack |
2014 |
For patients with a cryptogenic ischemic stroke or TIA and a PFO without evidence for DVT, available data do not support a benefit for PFO closure |
A |
N/A |
Prevention of stroke
|
AHA/ASA Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack |
2014 |
For patients with a recent (within 6 months) TIA or ischemic stroke ipsilateral to a stenosis or occlusion of the middle cerebral or carotid artery, EC/IC bypass surgery is not recommended |
A |
N/A |
Prevention of stroke
|
AHA/ASA Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack |
2014 |
Routine supplementation with a single vitamin or combination of vitamins is not recommended |
A |
N/A |
Prevention of stroke
|
AHA/ASA Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack |
2014 |
The combination of aspirin and clopidogrel, when initiated days to years after a minor stroke or TIA and continued for 2 to 3 years, increases the risk of hemorrhage relative to either agent alone and is not recommended for routine long-term secondary prevention after ischemic stroke or TIA |
A |
N/A |
Prevention of stroke
|
AHA/ASA Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack |
2014 |
When the degree of stenosis is <50%, CEA and CAS are not recommended |
A |
N/A |
Prevention of stroke
|
AHA/ASA Guidelines for the Primary Prevention of Stroke |
2011 |
Aspirin is not useful for preventing a first stroke in persons at low risk |
A |
N/A |
Primary prevention of stroke
|
AHA/ASA Guidelines for the Primary Prevention of Stroke |
2011 |
Hormone therapy (CEE with or without MPA) should not be used for primary prevention of stroke in postmenopausal women |
A |
N/A |
Primary prevention of stroke
|
AHA/ASA Guidelines for the Primary Prevention of Stroke |
2011 |
Screening for cardiac conditions such as PFO in the absence of neurological conditions or a specific cardiac cause is not recommended |
A |
N/A |
Primary prevention of stroke
|
AHA/ASA Guidelines for the Primary Prevention of Stroke |
2011 |
SERMs, such as raloxifene, tamoxifen, or tibolone, should not be used for primary prevention of stroke |
A |
N/A |
Primary prevention of stroke
|
AHA/ASA Guidelines for the Primary Prevention of Stroke |
2011 |
Treatment with antibiotics for chronic infections as a means to prevent stroke is not recommended |
A |
N/A |
Primary prevention of stroke
|
ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery |
2009 |
Routine use of a PAC perioperatively, especially in patients at low risk of developing hemodynamic disturbances, is not recommended. |
A |
N/A |
Perioperative Beta Blockade
|
ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease |
2012 |
Estrogen therapy is not recommended in postmenopausal women with SIHD with the intent of reducing cardiovascular risk or improving clinical outcomes. |
A |
No Benefit |
Stable ischemic heart disease
|
ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease |
2012 |
Treatment of elevated homocysteine with folate or vitamins B6 and B12 is not recommended with the intent of reducing cardiovascular risk or improving clinical outcomes in patients with SIHD |
A |
No Benefit |
Stable ischemic heart disease
|