Lifestyle management and secondary prevention of coronary artery disease

2021 ◽  
pp. 97-102
Author(s):  
Mansoor Ahmad ◽  
Sandra A. Weiss ◽  
William S. Weintraub
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Secondary Prevention ◽  
Recurrent Events ◽  
Lifestyle Modification ◽  
Heart Association ◽  
Prevention Measures ◽  
Cardiac Events ◽  
History Of ◽  
Artery Disease

Cardiovascular disease has been the leading cause of death in industrialized nations since the early 1900s. According to the American Heart Association, there are more than 1 million new and recurrent cardiac events occurring each year. Those with a history of cardiac ischaemic events have a high risk of recurrent events; however, the death rate from coronary artery disease declined from 1995 to 2005 by 26%. Thus, the burden of chronic non-fatal coronary artery disease remains high and therefore underscores the importance of secondary prevention measures. This chapter focuses on lifestyle modification, which is considered a major component of secondary prevention.

scholarly journals Patterns of Adherence to Secondary Prevention Measures Among Chinese Patients With Coronary Artery Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Minmin Lu ◽  
Marilyn Hravnak ◽  
Yuefang Chang ◽  
Ying Lin ◽  
Xian Zhang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Secondary Prevention ◽  
Chinese Patients ◽  
Prevention Measures ◽  
Artery Disease

Primary and Secondary Prevention of CAD: A Review

2021 ◽  
Author(s):  
Lindsay Short ◽  
Van T. La ◽  
Mandira Patel ◽  
Ramdas G. Pai
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Secondary Prevention ◽  
Health Care Providers ◽  
Clear Understanding ◽  
Care Providers ◽  
Primary And Secondary Prevention ◽  
Cardiac Events ◽  
Management Options ◽  
Artery Disease

AbstractCoronary artery disease is the leading cause of death in both men and women, yet adequate control of risk factors can largely reduce the incidence and recurrence of cardiac events. In this review, we discuss various life style and pharmacological measures for both the primary and secondary prevention of coronary artery disease. With a clear understanding of management options, health care providers have an excellent opportunity to educate patients and ameliorate a significant burden of morbidity and mortality.

Genetic predisposition to coronary artery disease is predictive of recurrent events: a Chinese prospective cohort study

2020 ◽  
Vol 29 (6) ◽  
pp. 1044-1053 ◽  
Author(s):  
Jie Jiang ◽  
Qiwen Zheng ◽  
Yaling Han ◽  
Shubin Qiao ◽  
Jiyan Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Secondary Prevention ◽  
Prediction Model ◽  
Recurrent Events ◽  
Genetic Risk Score ◽  
Major Adverse Cardiovascular Events ◽  
Increased Risk ◽  
Artery Disease

Abstract Evidence of the effects of genetic risk score (GRS) on secondary prevention is scarce and mixed. We investigated whether coronary artery disease (CAD) susceptible loci can be used to predict the risk of major adverse cardiovascular events (MACEs) in a cohort with acute coronary syndromes (ACSs). A total of 1667 patients hospitalized with ACS were enrolled and prospectively followed for a median of 2 years. We constructed a weighted GRS comprising 79 CAD risk variants and investigated the association between GRS and MACE using a multivariable cox proportional hazard regression model. The incremental value of adding GRS into the prediction model was assessed by integrated discrimination improvement (IDI) and decision curve analysis (DCA). In the age- and sex-adjusted model, each increase in standard deviation in the GRS was associated with a 33% increased risk of MACE (hazard ratio: 1.33; 95% confidence interval: 1.10–1.61; P = 0.003), with this association not attenuating after further adjustment for traditional cardiovascular risk factors. The addition of GRS to a prediction model of seven clinical risk factors and EPICOR prognostic model slightly improved risk stratification for MACE as calculated by IDI (+1.7%, P = 0.006; +0.3%, P = 0.024, respectively). DCA demonstrated positive net benefits by adding GRS to other models. GRS was associated with MACE after multivariable adjustment in a cohort comprising Chinese ACS patients. Future studies are needed to validate our results and further evaluate the predictive value of GRS in secondary prevention.

Perioperative Normothermia and Incidence of Cardiac Events

2018 ◽  
pp. 18-22
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Controlled Trial ◽  
Standard Of Care ◽  
Perioperative Period ◽  
Cardiac Risk ◽  
Cardiac Events ◽  
Cardiac Morbidity ◽  
History Of ◽  
Artery Disease

This chapter focuses on how to treat and manage patients with cardiac risk factors during noncardiac surgeries by asking the question: Does maintenance of perioperative normothermia with supplemental warming reduce the incidence of postoperative cardiac events? This was the first prospective, randomized controlled trial to examine the relationship between body temperature and cardiac outcomes in the perioperative period. Patients studied were required either to have a documented history of coronary artery disease or to be considered at high risk for coronary artery disease by established criteria. The study determined that maintenance of normothermia reduces perioperative cardiac morbidity. Maintenance of perioperative normothermia has become the standard of care.

P2503Clinical outcomes of discordant exercise electrocardiographic and echocardiographic findings in patients with chest pain and no history of coronary artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E.-S Im ◽  
I.-S Sohn
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Treadmill Exercise ◽  
Coronary Revascularization ◽  
Exercise Echocardiography ◽  
Cardiac Events ◽  
History Of ◽  
Artery Disease

Abstract Purposes The aim of this study was to evaluate comparative clinical outcomes of discordant electrocardiographic (ECG) and echocardiographic (Echo) findings compared to concordant findings during treadmill exercise echocardiography in patients with chest pain and no history of coronary artery disease (CAD). Methods A total of 1725 consecutive patients who underwent treadmill echocardiography with chest pain and no history of CAD were screened. The patients were classified into four groups: ECG−/Echo− (negative ECG and Echo), ECG+/Echo− (positive ECG and negative Echo), ECG−/Echo+, and ECG+/Echo+. Concomitant CAD was determined using coronary angiography or coronary computed tomography. Major adverse cardiac events (MACEs) were defined as a composite of coronary revascularization, acute myocardial infarction, and death. Results MACEs were similar between ECG−/Echo− and ECG+/Echo− groups. Compared to ECG+/Echo− group, ECG−/Echo+ group had more MACEs [adjusted hazard ratio (HR) adjusted by clinical risk factors (95% confidence interval), 3.57 (1.75–7.29), p<0.001]. Compared with ECG+/Echo+ group, ECG−/Echo+ group had lower prevalence of concomitant CAD and fewer MACEs [HR, 0.49 (0.29–0.81), p=0.006]. Conclusions Positive exercise Echo alone during treadmill exercise echocardiography had worse clinical outcomes than positive ECG alone, and the latter had similar outcomes to both negative ECG and Echo. Positive exercise Echo alone also had better clinical outcomes than both positive ECG and Echo. Therefore, exercise Echo findings might be superior for predicting clinical outcomes compared to exercise ECG findings. Additional consideration of ECG findings on positive exercise Echo will also facilitate better prediction of clinical outcomes

scholarly journals Incidence and Predictors of Obstructive Coronary Artery Disease and the Role of Cardiac Troponin Assays in Patients with Unstable Angina

2019 ◽  
Vol 46 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Sushan Yang ◽  
Nirmanmoh Bhatia ◽  
Meng Xu ◽  
John A. McPherson
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Unstable Angina ◽  
Obstructive Coronary Artery Disease ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
History Of ◽  
Male Sex ◽  
Artery Disease ◽  
Long Acting

In a time when cardiac troponin assays are widely used to detect myocardial injury, data remain scarce concerning the incidence and predictors of substantial obstructive coronary artery disease that causes unstable angina. This retrospective single-center study included consecutive patients hospitalized for unstable angina from January 2015 through January 2016. Patients with troponin I levels above the upper reference limit and those who did not undergo angiography were excluded. Multivariate logistic regression analysis was used to identify predictors of obstructive coronary artery disease that warranted revascularization and of major adverse cardiac events up to 6 months after discharge from the hospital. Of the 114 patients who met the inclusion criteria, 46 (40%) had obstructive coronary artery disease. In the univariate analysis, male sex, white race, history of coronary artery disease, prior revascularization, hyperlipidemia, chronic kidney disease, aspirin use, long-acting nitrate use, and Thrombolysis in Myocardial Infarction score ≥3 were associated with obstructive coronary artery disease. History of coronary artery disease, prior revascularization, hyperlipidemia, and long-acting nitrate use were associated with major adverse cardiac events. Male sex was an independent predictor of obstructive coronary artery disease (adjusted odds ratio=4.82; 95% CI, 1.79–13; P=0.002) in the multivariate analysis. Our results showed that coronary artery disease warranting revascularization is present in a considerable proportion of patients who have unstable angina. The association that we found between male sex and obstructive coronary artery disease suggests that the risk stratification of patients presenting with unstable angina may need to be refined to improve outcomes.

scholarly journals Dual Antiplatelet or Dual Antithrombotic Therapy for Secondary Prevention in High-Risk Patients with Stable Coronary Artery Disease?

2019 ◽  
Vol 119 (10) ◽  
pp. 1583-1589 ◽  
Author(s):  
Wael Sumaya ◽  
Tobias Geisler ◽  
Steen D. Kristensen ◽  
Robert F. Storey
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Secondary Prevention ◽  
Dual Antiplatelet Therapy ◽  
Stable Coronary Artery Disease ◽  
Risk Patients ◽  
History Of ◽  
Artery Disease

AbstractAntithrombotic treatment is a key component of secondary prevention following acute coronary syndromes (ACS). Although dual antiplatelet therapy is standard therapy post-ACS, duration of treatment is the subject of ongoing debate. Prolonged dual antiplatelet therapy in high-risk patients with history of myocardial infarction reduced the risk of recurrent myocardial infarction, stroke or cardiovascular death. Similarly, in patients with stable coronary artery disease, two-thirds of whom had a history of myocardial infarction, dual antithrombotic therapy with very-low-dose rivaroxaban and aspirin also resulted in improved ischaemic outcomes. In the absence of head-to-head comparison, choosing the most appropriate treatment strategy can be challenging, particularly when it comes to balancing the risks of ischaemia and bleeding. We aim to review the evidence for currently available antithrombotic treatments and provide a practical algorithm to aid the decision-making process.

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