Document Detail


Medical management of stable coronary artery disease.
MedLine Citation:
PMID:  21524048     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
All patients with stable coronary artery disease require medical therapy to prevent disease progression and recurrent cardiovascular events. Three classes of medication are essential to therapy: lipid-lowering, antihypertensive, and antiplatelet agents. Lipid-lowering therapy is necessary to decrease low-density lipoprotein cholesterol to a target level of less than 100 mg per dL, and physicians should consider a goal of less than 70 mg per dL for very high-risk patients. Statins have demonstrated clear benefits in morbidity and mortality in the secondary prevention of coronary artery disease; other medications that can be used in addition to statins to lower cholesterol include ezetimibe, fibrates, and nicotinic acid. Blood pressure therapy for patients with coronary artery disease should start with beta blockers and angiotensin-converting enzyme inhibitors. If these medications are not tolerated, calcium channel blockers or angiotensin receptor blockers are acceptable alternatives. Aspirin is the first-line antiplatelet agent except in patients who have recently had a myocardial infarction or undergone stent placement, in which case clopidogrel is recommended. Anginal symptoms of coronary artery disease can be treated with beta blockers, calcium channel blockers, nitrates, or any combination of these. Familiarity with these medications and with the evidence supporting their use is essential to reducing morbidity and mortality in patients with coronary artery disease.
Authors:
Matthew Pflieger; Bradford T Winslow; Kyle Mills; Ira M Dauber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American family physician     Volume:  83     ISSN:  1532-0650     ISO Abbreviation:  Am Fam Physician     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1272646     Medline TA:  Am Fam Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  819-26     Citation Subset:  AIM; IM    
Affiliation:
Clinica Family Health Services, Denver, CO, USA.
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