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Health Care Guidelines

Guidelines, order sets, protocols and more.

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Scope and Target Population:
Adults aged 18 and over who meet the stated guideline criteria as identified in Annotation #1, "Patient with Stable Coronary Artery Disease."

Clinical Highlights and Recommendations:
  • Prescribe aspirin in patients with stable coronary artery disease if there are no medical contraindications.
  • Evaluate and treat the modifiable risk factors, which include smoking, sedentary activity level, stress, hyperlipidemia, obesity, hypertension and diabetes.
  • Patients with chronic stable coronary artery disease should be on statin therapy regardless of their lipid levels unless contraindicated.
  • Perform prognostic testing in patients whose risk determination remains unclear. This may precede or follow an initial course of pharmacologic therapy.
  • Refer the patient for cardiovascular consultation when clinical assessment indicates the patient is at high risk for adverse events, the non-invasive imaging study or EKG indicates the patient is at high risk for an adverse event, or medical treatment is ineffective.
  • For relief of angina, prescribe beta-blockers as first-line medication. If beta-blockers are contraindicated, nitrates are the preferred alternative. Calcium channel blockers may be an alternative medication if the patient is unable to take beta-blockers or nitrates.
Priority Aims
  1. Improve selection and education of patients with stable CAD on the use of aspirin and antianginal drugs.
  2. Improve patient understanding of management of stable CAD.
  3. Increase the percentage of patients with stable CAD who receive an intervention for modifiable risk factors.
  4. Improve assessment of patient's anginal symptoms.
  5. Increase the use of ACE inhibitors in all patients with CAD who also have diabetes and/or LVSD, or other cardiovascular diseases.

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