Optimal Medical Therapy, Lifestyle Intervention, and Secondary Prevention Strategies for Cardiovascular Event Reduction in Ischemic Heart Disease

Abstract

Medical and lifestyle secondary prevention strategies are essential components for reducing cardiovascular risk, irrespective of whether revascularization is performed. In patients with coronary artery disease (CAD), recent clinical trials have further clarified the management of lipid optimization, renin-angiotensin-aldosterone system inhibition, antiplatelet therapy, and diabetes. Still, many questions remain with regard to optimal secondary prevention strategies in patients with CAD. Despite the significant reductions in cardiovascular morbidity and mortality with secondary prevention therapies demonstrated in clinical trials, long-term adherence to these interventions remains relatively low, with reasons being multifactorial. One promising method to improve compliance is the use of trained nurses/case managers to routinely follow medications, and provide both lifestyle and behavioral counseling. Implementation of this strategy led to significant improvements in medication compliance and risk factor optimization, although these results require confirmation in a randomized clinical study. Given that poor compliance has been associated with worsening cardiovascular outcomes, effective CAD management should include strategies for improving patient adherence to therapies that have proven benefits.

Fatty liver predicts the risk for cardiovascular events in middle-aged population: a population-based cohort study

“…All participants who had myocardial infarction or stroke before baseline were excluded because a history of myocardial infarction is known to increase the risk for recurrent myocardial infarction or cardiovascular death 39 and medication as well as lifestyle secondary prevention strategies are intensive. 40 There are a few follow-up-studies examining whether the fatty liver increases the risk for total mortality. 13 41 In the present study, severe fatty liver predicted the risk for overall mortality of any causes when age, gender and study group were added covariates, a result in line with an earlier report.…”

Effects of Nurse-Managed Protocols in the Outpatient Management of Adults With Chronic Conditions

“…Robust evidence supports the effectiveness of nurses in providing patient education about chronic disease and secondary prevention strategies (14)(15)(16)(17)(18)(19). Robust evidence supports the effectiveness of nurses in providing patient education about chronic disease and secondary prevention strategies (14)(15)(16)(17)(18)(19).…”

High On-Treatment Platelet Reactivity in Peripheral Arterial Disease: A Pilot Study to Find the Optimal Test and Cut Off Values

“…However, APT is also prescribed to prevent secondary CVEs. 34,35 With regard to the latter, other expressions of platelet activation than aggregate formation (VerifyNow) might be more relevant and should be tested in platelet reactivity testing. More studies on differential platelet activation and the clinical consequences should be assessed.…”