This guideline offers a patient-centered approach to managing chronic coronary disease, considering social factors and emphasizing shared decision-making and team-based care. It covers topics like treatment decisions, symptom and cardiovascular event reduction, revascularization choices, special populations, patient follow-up, and areas for future research.

10 key takeaways for managing Chronic Coronary Disease:

1. Prioritize patient-centred, team-based care considering social factors and cost, while involving shared decision-making in risk assessment and treatment planning.
2. Prioritize patient-centred, team-based care considering social factors and cost, while involving shared decision-making in risk assessment and treatment planning.
3. Promote regular physical activity, including aerobic and resistance exercises, for CCD patients without contraindications. Cardiac rehabilitation offers significant cardiovascular benefits.
4. Consider using sodium glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists for specific CCD patient groups, even those without diabetes.
5. New beta-blocker recommendations: Avoid long-term use without recent heart attack, reduced left ventricular ejection fraction, or another primary indication.
6. Statins remain the primary therapy for lipid management in CCD patients. Additional therapies like ezetimibe and PCSK9 inhibitors may be considered in specific cases.
7. Shorter durations of dual antiplatelet therapy are safe and effective, especially in situations where bleeding risk is high and ischemic risk is moderate.
8. Avoid non-prescription or dietary supplements like fish oil and vitamins for CCD patients, as they don’t significantly reduce cardiovascular events.
9. Routine anatomic or ischemic testing is unnecessary if there’s no change in clinical or functional status in CCD patients.
10. While e-cigarettes can aid smoking cessation, they are not recommended as the first-line therapy due to limited long-term safety data and potential risks associated with sustained use.

Source: Members WC, Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, Dixon DL, Fearon WF, Hess B, Johnson HM. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2023 Jul 20.

Reference Link:

1. American Heart Association, Inc.