August 30, 2023

CAD: ACC/AHA 2023 Chronic Coronary Disease Guideline Key Points: J Am Coll Cardiol. 2023 Aug, 82 (9) 956–960

3 minutes

These are the key points from this 2023 ACC/AHA guideline in managing chronic coronary disease.

Patients with chronic coronary disease should receive care from a team of healthcare professionals (Team-based, patient-centered care)

All patients with chronic coronary disease should be encouraged to make healthy lifestyle changes (nonpharmacologic therapies).

Patients with chronic coronary disease who can exercise should be encouraged to participate in habitual physical activity.

Sodium-glucose cotransporter two inhibitors and glucagon-like peptide-1 receptor agonists can be helpful for some patients with chronic coronary disease.

Beta-blockers are no longer recommended for all patients with chronic coronary disease except in people who have had a heart attack in the past year, have a left ventricular ejection fraction of less than 50%, or have another condition that requires them to take beta-blockers.

Statins are still the first-line therapy for lowering cholesterol in patients with chronic coronary disease. Consider PCSK9i, inclisiran, and bempedoic acid as alternative or additional therapies.

Shorter durations of dual antiplatelet therapy are safe and effective in many patients with chronic coronary disease.

There is no evidence that nonprescription or dietary supplements benefit patients with chronic coronary disease.

Routine periodic anatomic or ischemic testing is not recommended for risk stratification or to guide therapeutic decision-making in patients with chronic coronary disease.

E-cigarettes increase the likelihood of successful smoking cessation compared with nicotine replacement therapy, but they are not recommended as first-line therapy for smoking cessation.

Reference article: https://doi.org/10.1016/j.jacc.2023.06.006

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By Bishnu Subedi