8/06/2008

SECONDARY PREVENTION FOR PATIENT WITH CORONARY ARTERY DISEASE (AHA/ACC 2006)

Smoking

Complete cessation

No exposure to environmental tobacco smoke

Blood Pressure Control


130/80mmhg

Lipid Management

LDL-C, less than 2.0mmol/l

Physical Activity

30 minutes, 7 days per week

Weight Management

BMI 18 to 23kg/m2

Waist circumference (Men <38>

Diabetes Management

HbA1c <7%

Antiplatelet

Aspirin indefinitely (75 to 162mg daily)

Add Clopidogrel 75mg daily post acute coronary syndrome or stenting

Warfarin for AF

Renin Angiotension Aldosterone blockers

ACE Inhibitors for all patients

ARB for ACE Inhibitor intolerance

ACE Inhibitor and ARB combination for heart failure

Aldosterone receptor blocker for NYHA class III and IV

Beta Blockers

Myocardial infarction, acute coronary syndrome, heart failure


Secondary prevention: "Post cardiac event"