Q&A

Guidelines for the treatment of chronic stable angina

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  • CLINICAL QUESTION: In patients with chronic stable angina or those who are asymptomatic but who have evidence of coronary artery disease, what is the appropriate medical management?
  • STUDY DESIGN: Practice guideline
  • SETTING: Various (guideline)
  • SYNOPSIS: The American College of Physicians endorses the American College of Cardiology/American Heart Association guidelines from 2002. The guidelines apply to patients with chronic stable angina who have not had a myocardial infarction (MI) or have undergone revascularization in the past 6 months, as well as patients who are asymptomatic but have demonstrated evidence of coronary artery disease. The strength of the recommendations (SOR) are characterized as follows: A = several randomized clinical trials with large numbers of patients; B = limited number of randomized trials with small numbers of patients, nonrandomized studies, or observational registries; and C = expert consensus.


 

BOTTOM LINE

In patients who have either chronic stable angina without a history of myocardial infarction or a revascularization procedure in the past 6 months, as well as in asymptomatic patients with demonstrated coronary artery disease, the following should be routine: aspirin; a beta-blocker; an angiotensin-converting enzyme inhibitor; and a statin, if the cholesterol is above normal. (LOE=1a)

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