Document Detail


Secondary prevention of coronary artery disease.
MedLine Citation:
PMID:  20112887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary artery disease is the leading cause of mortality in the United States. In patients who have had a myocardial infarction or revascularization procedure, secondary prevention of coronary artery disease by comprehensive risk factor modification reduces mortality, decreases subsequent cardiac events, and improves quality of life. Options for secondary prevention include medical therapy and surgical revascularization in the form of coronary artery bypass grafting or percutaneous coronary intervention. Medical therapy focuses on comprehensive risk factor modification. Therapeutic lifestyle changes (including weight management, physical activity, tobacco cessation, and dietary modification) improve cardiac risk factors and are universally recommended by evidence-based guidelines. Treatment of hypertension and dyslipidemia reduces morbidity and mortality. Recommendations for persons with diabetes mellitus generally encourage glucose control, but current evidence has not shown reductions in mortality with intensive glucose management. Aspirin, angiotensin-converting enzyme inhibitors, and beta blockers reduce recurrent cardiac events in patients after myocardial infarction. Surgical revascularization by coronary artery bypass grafting is recommended for those with significant left main coronary artery stenosis, significant stenosis of the proximal left anterior descending artery, multivessel coronary disease, or disabling angina. Percutaneous coronary intervention may be considered in select patients with objective evidence of ischemia demonstrated by noninvasive testing.
Authors:
Scott L Hall; Todd Lorenc
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American family physician     Volume:  81     ISSN:  1532-0650     ISO Abbreviation:  Am Fam Physician     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1272646     Medline TA:  Am Fam Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  289-96     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 American Academy of Family Physicians.
Affiliation:
University of Nevada School of Medicine, Reno, NV 89557, USA. shallmd@specialtyhealth.com
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Anticholesteremic Agents / therapeutic use
Coronary Artery Disease / prevention & control*
Depression / prevention & control
Diabetes Mellitus / prevention & control
Diet
Exercise
Humans
Hypertension / prevention & control
Platelet Aggregation Inhibitors / therapeutic use
Risk Factors
Risk Reduction Behavior
Tobacco Use Cessation
Weight Loss
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Anticholesteremic Agents; 0/Platelet Aggregation Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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