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Preventing heart attack and death in patients with coronary disease
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JACC Vol. 26, No. 1 July 1995:292-4
AHA CONSENSUS PANEL STATEMENT Preventing Heart Attack and Death in Patients With Coronary Disease SIDNEY C. SMITH, JR., MD, FACC, STEVEN N. BLAIR, PED, MICHAEL H. CRIQUI, MD, GERALD F. FLETCHER, MD, FACC, VALENTIN FUSTER, MD, PHD, FACC, BERNARD J. GERSH, MD, PHD, FACC, ANTONIO M. GOTFO, MD, FACC, K. LANCE GOULD, MD, FACC, PHILIP GREENLAND, MD, FACC, SCOTT M. GRUNDY, MD, PHD, MARTHA N. HILL, PHD, RN, MARK A. HLATKY, MD, FACC, NANCY HOUSTON-MILLER, RN, RONALD M. KRAUSS, MD, JOHN LAROSA, MD, IRA S. OCKENE, MD, FACC, SUZANNE OPARIL, MD, FACC, THOMAS A. PEARSON, MD, FACC, ELLIOT RAPAPORT, MD, FACC, RODMAN D. STARKE, MD, FACC, THE SECONDARYPREVDmON PAtroL Endorsed by the Board of Trustees of the American College ~)1Cardiology
Compelling scientific evidence, including data from recent studies in patients with coronary artery, disease, demonstrates that comprehensive risk factor interventions: • Extend overall survival • Improve quality of life • Decrease need for interventiona[ procedures such as angioplasty and bypass grafting, and • Reduce the incidence of subsequent myocardial infarction Application of risk reduction tactics to the more than 11 million people with coronary disease--most of whom already receive medical care--will improve overall patient outcomes and should reduce the economic burden of heart disease. In selected patients with coronary artery disease, comprehensive risk intervention may provide satisfactory initial management, allowing postponement of or even obviating revascularization procedures. Clinical trial data that support these recommendations derive from studies of myocardial infarction survivors and other patients with diagnosed coronary disease. However, the rationale for this approach extends to patients with other documented atherosclerotic vascular disease--for example, transient ischemic attack, stroke, "Preventing Heart Attack and Death in Patients With Coronary Disease" was approved by the SAC/Steering Committee of the American Heart Association on April 14, 1995. Reprint requests to the Oltice of Scientific Affairs. American Heart Association, 7272 Greenville Ave, Dallas, TX 75231-4596. © 1995 American Heart Association. Inc.
or aortic or peripheral vascular disease--because coronary artery disease is a leading cause of death and disability in these patient groups. Although these risk reduction interventions significantly improve clinical outcomes, their application is inconsistent across medical care settings and patient groups. The American Heart Association urges that every effort be made throughout the spectrum of medical care to promote more comprehensive application of risk reduction in all eligible patients. The present consensus summary is presented as a guide to help prevent further cardiac events and death in patients with coronary and other vascular disease. More intensive efforts in applying these risk reduction strategies to all patients at the time of first diagnosis will improve both quality of life and overall outcome for this group of patients and most likely will reduce healthcare costs. Studies have demonstrated that only approximately one third of eligible patients continue risk factor interventions over the long term. However, data also show that this proportion can be significantly increased by a team approach in which healthcare professionals-including physicians, nurses, and dietitians--manage risk reduction therapy by using follow-up techniques that include once or clinic visits and telephone contact. Attention to enhancing patient compliance is an integral part of any risk reduction program. In many healthcare settings, the team approach will be the preferred technique for optimizing risk reduction.
JACC Vol. 26, No. 1 July 1995:292-4
AHA CONSENSUS PANEL STATEMENT Preventing Heart Attack and Death in Patients With Coronary Disease SIDNEY C. SMITH, JR., MD, FACC, STEVEN N. BLAIR, PED, MICHAEL H. CRIQUI, MD, GERALD F. FLETCHER, MD, FACC, VALENTIN FUSTER, MD, PHD, FACC, BERNARD J. GERSH, MD, PHD, FACC, ANTONIO M. GOTFO, MD, FACC, K. LANCE GOULD, MD, FACC, PHILIP GREENLAND, MD, FACC, SCOTT M. GRUNDY, MD, PHD, MARTHA N. HILL, PHD, RN, MARK A. HLATKY, MD, FACC, NANCY HOUSTON-MILLER, RN, RONALD M. KRAUSS, MD, JOHN LAROSA, MD, IRA S. OCKENE, MD, FACC, SUZANNE OPARIL, MD, FACC, THOMAS A. PEARSON, MD, FACC, ELLIOT RAPAPORT, MD, FACC, RODMAN D. STARKE, MD, FACC, THE SECONDARYPREVDmON PAtroL Endorsed by the Board of Trustees of the American College ~)1Cardiology
Compelling scientific evidence, including data from recent studies in patients with coronary artery, disease, demonstrates that comprehensive risk factor interventions: • Extend overall survival • Improve quality of life • Decrease need for interventiona[ procedures such as angioplasty and bypass grafting, and • Reduce the incidence of subsequent myocardial infarction Application of risk reduction tactics to the more than 11 million people with coronary disease--most of whom already receive medical care--will improve overall patient outcomes and should reduce the economic burden of heart disease. In selected patients with coronary artery disease, comprehensive risk intervention may provide satisfactory initial management, allowing postponement of or even obviating revascularization procedures. Clinical trial data that support these recommendations derive from studies of myocardial infarction survivors and other patients with diagnosed coronary disease. However, the rationale for this approach extends to patients with other documented atherosclerotic vascular disease--for example, transient ischemic attack, stroke, "Preventing Heart Attack and Death in Patients With Coronary Disease" was approved by the SAC/Steering Committee of the American Heart Association on April 14, 1995. Reprint requests to the Oltice of Scientific Affairs. American Heart Association, 7272 Greenville Ave, Dallas, TX 75231-4596. © 1995 American Heart Association. Inc.
or aortic or peripheral vascular disease--because coronary artery disease is a leading cause of death and disability in these patient groups. Although these risk reduction interventions significantly improve clinical outcomes, their application is inconsistent across medical care settings and patient groups. The American Heart Association urges that every effort be made throughout the spectrum of medical care to promote more comprehensive application of risk reduction in all eligible patients. The present consensus summary is presented as a guide to help prevent further cardiac events and death in patients with coronary and other vascular disease. More intensive efforts in applying these risk reduction strategies to all patients at the time of first diagnosis will improve both quality of life and overall outcome for this group of patients and most likely will reduce healthcare costs. Studies have demonstrated that only approximately one third of eligible patients continue risk factor interventions over the long term. However, data also show that this proportion can be significantly increased by a team approach in which healthcare professionals-including physicians, nurses, and dietitians--manage risk reduction therapy by using follow-up techniques that include once or clinic visits and telephone contact. Attention to enhancing patient compliance is an integral part of any risk reduction program. In many healthcare settings, the team approach will be the preferred technique for optimizing risk reduction.