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Patients who should be treated with secondary prevention are those with established atherosclerosis including peripheral artery
Patients who should be treated with secondary prevention are those with established atherosclerosis including peripheral artery
disease; carotid artery disease; atherosclerotic aortic disease; diabetes and those with a Framingham Risk Score of > 20%.
disease; carotid artery disease; atherosclerotic aortic disease; diabetes and those with a Framingham Risk Score of > 20%.
There are 10 aspects of secondary prevention: Smoking cessation; blood pressure control; lipid-lowering; increasing physical activity; weight loss; diabetes control;  antiplatelet agents/anticoagulants; RAS blockers; beta-blockers and influenza vaccine.
There are 12 aspects of secondary prevention: Smoking cessation; blood pressure control; lipid-lowering; increasing physical activity; weight loss; diabetes control;  antiplatelet agents/anticoagulants; RAS blockers; beta-blockers; depression management; cardiac rehabilitation and influenza vaccine. Please note that secondary prevention guidelines, especially, those involving medication, may differ between [[Unstable Angina|UA/NSTEMI]]; [[STEMI]]; and [[Chronic Stable Angina]]. Please refer to appropriate page for more specific guidelines.


==[[Coronary heart disease secondary prevention target population | Target Population]]==
==[[Coronary heart disease secondary prevention target population | Target Population]]==
Line 17: Line 17:
==[[Coronary heart disease secondary prevention weight management | Weight Management]]==
==[[Coronary heart disease secondary prevention weight management | Weight Management]]==
==[[Coronary heart disease secondary prevention influenza vaccination | Influenza Vaccination]]==
==[[Coronary heart disease secondary prevention influenza vaccination | Influenza Vaccination]]==
==[[Coronary heart disease secondary prevention ACE inhibition | ACE Inhibition]]==
==[[Coronary heart disease secondary prevention depression | Depression]]==
==[[Coronary heart disease secondary prevention depression | Depression]]==
==[[Coronary heart disease secondary prevention beta-blockers | Beta Blockers]]==
==[[Coronary heart disease secondary prevention beta-blockers | Beta Blockers]]==
==[[Coronary heart disease secondary prevention diabetes mellitus management | Diabete Mellitus Management]]==
==[[Coronary heart disease secondary prevention diabetes mellitus management | Diabete Mellitus Management]]==
==[[Coronary heart disease secondary prevention antiplatelet agents/anticoagulants | Antiplatelet agents/anticoagulants]]==
==[[Coronary heart disease secondary prevention antiplatelet agents/anticoagulants | Antiplatelet Agents/Anticoagulants]]==
 
==[[Coronary heart disease secondary prevention renin-angiotensin-aldosterone system blockers |Renin-angiotensin-aldosterone system blockers]]==
==[[Coronary heart disease secondary prevention renin-angiotensin-aldosterone system blockers |Renin-angiotensin-aldosterone system blockers]]==
==[[Coronary heart disease secondary prevention cardiac rehabilitation | Cardiac Rehabilitation]]==
==[[Coronary heart disease secondary prevention cardiac rehabilitation | Cardiac Rehabilitation]]==


=== Anti-platelet therapy ===
==References==
A [[meta-analysis]] of [[randomized controlled trials]] by the international [[Cochrane Collaboration]] found "that the use of clopidogrel plus aspirin is associated with a reduction in the risk of cardiovascular events compared with aspirin alone in patients with acute non-ST coronary syndrome. In patients at high risk of cardiovascular disease but not presenting acutely, there is only weak evidence of benefit and hazards of treatment almost match any benefit obtained.".<ref name="pmid17636787">{{cite journal |author=Keller T, Squizzato A, Middeldorp S |title=Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular disease |journal=Cochrane database of systematic reviews (Online) |volume= |issue=3 |pages=CD005158 |year=2007 |pmid=17636787 |doi=10.1002/14651858.CD005158.pub2}}</ref>
{{reflist|2}}


==Sources==
[[Category:Cardiology]]
*AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update<ref name="pmid16697342">{{cite journal| author=AHA. ACC. National Heart, Lung, and Blood Institute. Smith SC, Allen J, Blair SN et al.| title=AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update endorsed by the National Heart, Lung, and Blood Institute. | journal=J Am Coll Cardiol | year= 2006 | volume= 47 | issue= 10 | pages= 2130-9 | pmid=16697342 | doi=10.1016/j.jacc.2006.04.026 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16697342  }} </ref>
[[Category:Disease]]
*2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction <ref name="pmid22800849">{{cite journal| author=2012 Writing Committee Members. Jneid H, Anderson JL, Wright RS, Adams CD, Bridges CR et al.| title=2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=Circulation | year= 2012 | volume= 126 | issue= 7 | pages= 875-910 | pmid=22800849 | doi=10.1161/CIR.0b013e318256f1e0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22800849}} </ref>
*The ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction <ref name="pmid17692738">{{cite journal |author=Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE, Chavey WE, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS, Smith SC, Jacobs AK, Adams CD, Anderson JL, Antman EM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Ornato JP, Page RL, Riegel B |title=ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine |journal=[[Journal of the American College of Cardiology]] |volume=50 |issue=7 |pages=e1–e157 |year=2007 |month=August |pmid=17692738 |doi=10.1016/j.jacc.2007.02.013 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(07)00511-6 |accessdate=2011-04-12}}</ref>


== References ==
{{WH}}
{{Reflist|2}}
{{WS}}

Latest revision as of 20:53, 8 January 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Patients who should be treated with secondary prevention are those with established atherosclerosis including peripheral artery disease; carotid artery disease; atherosclerotic aortic disease; diabetes and those with a Framingham Risk Score of > 20%. There are 12 aspects of secondary prevention: Smoking cessation; blood pressure control; lipid-lowering; increasing physical activity; weight loss; diabetes control; antiplatelet agents/anticoagulants; RAS blockers; beta-blockers; depression management; cardiac rehabilitation and influenza vaccine. Please note that secondary prevention guidelines, especially, those involving medication, may differ between UA/NSTEMI; STEMI; and Chronic Stable Angina. Please refer to appropriate page for more specific guidelines.

Target Population

Patient Education

Smoking Cessation

Blood Pressure Control

Lipid Management

Physical Activity Recommendations

Weight Management

Influenza Vaccination

Depression

Beta Blockers

Diabete Mellitus Management

Antiplatelet Agents/Anticoagulants

Renin-angiotensin-aldosterone system blockers

Cardiac Rehabilitation

References

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