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Exercise Stress Testing: Indications and Common Questions - American Family Physician

Sep 1, 2017 - Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p293.html

Acute Coronary Syndrome: Current Treatment - American Family Physician

Feb 15, 2017 - Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0215/p232.html

Coronary Artery Disease/Coronary Heart Disease - American Family Physician

Nov 1, 2019 - This collection features AFP content on coronary artery disease (CAD), coronary heart disease (CHD) and related issues, including acute coronary syndrome, angina, cardiomyopathy, hypertension, and myocardial infarction. This collection features AFP content on coronary artery disease ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=4

Stable Coronary Artery Disease: Treatment - American Family Physician

Mar 15, 2018 - Stable coronary artery disease refers to a reversible supply/demand mismatch related to ischemia, a history of myocardial infarction, or the presence of plaque documented by catheterization or computed tomography angiography. Patients are considered stable if they are asymptomatic or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p376.html

Acute Coronary Syndrome: Diagnostic Evaluation - American Family Physician

Feb 1, 2017 - Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p170.html

Myocardial Infarction: Management of the Subacute Period - American Family Physician

Nov 1, 2013 - Optimal management of myocardial infarction in the subacute period focuses on improving the discharge planning process, implementing therapies early to prevent recurrent myocardial infarction, and avoiding hospital readmission. Evidence-based guidelines for the care of patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1101/p581.html

Diet and Physical Activity for Cardiovascular Disease Prevention - American Family ...

Jun 1, 2016 - Cardiovascular disease (CVD) is the leading cause of death in the United States. One-third of these deaths may be preventable through healthy lifestyle choices including diet and physical activity. The Mediterranean diet is associated with reduced cardiovascular mortality, whereas the ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p919.html

Cardiac Rehabilitation: Improving Function and Reducing Risk - American Family Physician

Jul 1, 2016 - Cardiac rehabilitation is a comprehensive multidisciplinary program individually tailored to the needs of patients with cardiovascular disease. The overall goals focus on improving daily function and reducing cardiovascular risk factors. Cardiac rehabilitation includes interventions ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p37.html

Cholesterol Management: ACC/AHA Updates Guideline - Practice Guidelines - American ...

May 1, 2019 - The American College of Cardiology/American Heart Association (ACC/AHA) task force on clinical practice guidelines has updated its 2013 cholesterol guideline.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0501/p589.html

Medical Management of Stable Coronary Artery Disease - American Family Physician

Apr 1, 2011 - All patients with stable coronary artery disease require medical therapy to prevent disease progression and recurrent cardiovascular events. Three classes of medication are essential to therapy: lipid-lowering, antihypertensive, and antiplatelet agents. Lipid-lowering therapy is ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0401/p819.html

Rethinking Aspirin for the Primary Prevention of Cardiovascular Disease - Editorials - ...

Jun 1, 2019 - Aspirin's routine use for primary prevention has been the subject of controversy because of questionable benefits and increased bleeding risk. Aspirin therapy may reduce the relative risk of a first heart attack or stroke, but this benefit could be outweighed by the risk of ...

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0601/p670.html

Global Risk of Coronary Heart Disease: Assessment and Application - American Family ...

Aug 1, 2010 - Coronary heart disease is the most common cause of death in the United States. The conventional risk factor approach to primary prevention excludes many patients who could benefit from preventive therapies. A global risk approach allows more accurate estimates of risk to guide clinical ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0801/p265.html

Ticagrelor Compared to Clopidogrel in Acute Coronary Syndrome and Stable Coronary ...

Nov 1, 2019 - The authors determined there is no benefit from the use of ticagrelor in patients with acute coronary syndrome and stable coronary artery disease because of the uncertainty about benefits and evidence of potential harms.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1101/od1.html

Secondary Prevention of Coronary Artery Disease - American Family Physician

Feb 1, 2010 - Coronary artery disease is the leading cause of mortality in the United States. In patients who have had a myocardial infarction or revascularization procedure, secondary prevention of coronary artery disease by comprehensive risk factor modification reduces mortality, decreases ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0201/p289.html

Dual Antiplatelet Therapy for Patients with Cardiovascular Disease - FPIN's Clinical ...

Oct 15, 2019 - Patients with established cardiovascular disease or risk factors (e.g., ischemic cerebrovascular disease, peripheral arterial disease, high risk of atherothrombotic disease) should receive dual antiplatelet therapy with aspirin plus clopidogrel, which confers additional benefit over ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/1015/p463.html

Dual Antiplatelet Therapy for High-Risk TIA and Minor Stroke: BMJ Rapid Recommendation ...

Sep 15, 2019 - Based on a recent randomized controlled trial followed by a systematic review, the BMJ and MAGIC group concluded that dual antiplatelet therapy use for a limited period after mild stroke is beneficial.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0915/p378.html

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: ...

Jan 15, 2017 - The USPSTF recommends that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or ischemic stroke) use a low- to moderate-dose statin for the prevention of CVD events and mortality when all of the following criteria are met: (1) they are ...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2017/0115/od1.html

Sudden Cardiac Death and Implantable Cardioverter-Defibrillators - American Family ...

Dec 1, 2010 - Sudden cardiac death is a major public health problem, affecting 500,000 patients in the United States annually. An implantable cardioverter-defibrillator (ICD) can terminate malignant ventricular arrhythmias and has been shown to improve survival in high-risk populations. Although ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1201/p1357.html

ACC/AHA Guideline Update for the Management of ST-Segment Elevation Myocardial ...

Jun 15, 2009 - The American College of Cardiology and American Heart Association, in collaboration with the Canadian Cardiovascular Society, have issued an update of the 2004 guideline for the management of patients with ST-segment elevation myocardial infarction. The American Academy of Family ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0615/p1080.html

Cardiomyopathy: An Overview - American Family Physician

May 1, 2009 - Cardiomyopathy is an anatomic and pathologic diagnosis associated with muscle or electrical dysfunction of the heart. Cardiomyopathies represent a heterogeneous group of diseases that often lead to progressive heart failure with significant morbidity and mortality. Cardiomyopathies may ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0501/p778.html

Overview of New ACC/AHA Lipid Guidelines - POEMs - American Family Physician

Jun 1, 2019 - These updated guidelines, made without any input from primary care physicians who manage most patients with hyperlipidemia, are more complex than the 2013 guidelines and will likely lead to even more recommendations for statins, ezetimibe (Zetia), and PSK9 inhibitors.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p716.html

Applying a Clinical Decision Rule for CAD in Primary Care to Select a Diagnostic Test ...

May 1, 2019 - Using the INTERCHEST chest pain decision rule to decide next steps when a patient presents to a primary care physician with chest pain.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0501/p584.html

Omega-3 Fatty Acids Do Not Prevent Cancer or Cardiovascular Disease Events - POEMs - ...

Sep 15, 2019 - This is the second large, well-designed study (the first one included patients with diabetes mellitus; this one included patients without diabetes) that found no benefit from a 1-g daily dosage of marine n-3 fatty acid supplementation for the primary prevention of cardiovascular disease...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374a.html

Vitamin D Is Not Effective as Primary Prevention of Cardiovascular Disease or Cancer - ...

Sep 15, 2019 - Vitamin D supplementation does not prevent cardiovascular events or cancer in mostly nondiabetic adults (men 50 years and older, women 55 years and older).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374.html

Omega-3 Fatty Acids and Cardiovascular Disease Prevention - Medicine by the Numbers - ...

Aug 15, 2019 - High-quality evidence suggests that long-chain omega-3 polyunsaturated fatty acids do not prevent mortality (all-cause or cardiovascular) or cardiovascular disease events when used as primary or secondary prevention. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0815/p209.html

Drug-Eluting Coronary Artery Stents - American Family Physician

Dec 1, 2009 - Many advances have been made in the percutaneous treatment of coronary artery disease during the past 30 years. Although balloon angioplasty alone is still performed, the use of coronary artery stents is much more common. Approximately 40 percent of patients treated with balloon ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1201/p1245.html

Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with...

Dec 15, 2018 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for peripheral artery disease (PAD) and cardiovascular disease (CVD) risk with the ankle-brachial index (ABI) in asymptomatic adults.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2018/1215/od1.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

In Healthy Older Adults, Low-Dose Aspirin Increases All-Cause and Cancer-Specific ...

Jul 15, 2019 - The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118a.html

Depression After ACS Events: AAFP Releases Updated Guidelines - Practice Guidelines - ...

Jun 15, 2019 - The American Academy of Family Physicians has released a guideline focusing on depression in adults within three months of an ACS event (unstable angina or myocardial infarction). The guideline is based on a systematic review of randomized controlled trials and observational studies and...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0615/p785.html

Omega-3 Oil Does Not Reduce Serious Cardiovascular Events for Patients with Diabetes ...

Jul 15, 2019 - In this study, there was no significant difference in the likelihood of a composite vascular outcome or all-cause mortality in patients given an omega-3 fatty acid supplement compared with those given an olive oil placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p120.html

Myocardial Infarction: Expert Consensus Group Provides Updated Definition - Practice ...

Mar 1, 2019 - An expert consensus group of the European Society of Cardiology, American College of Cardiology Foundation, American Heart Association, and World Heart Federation has provided an updated universal definition of myocardial infarction.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0301/p334.html

Risk Assessment for Cardiovascular Disease with Nontraditional Risk Factors: ...

Jan 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adding the ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, or coronary artery calcium score to traditional risk assessment for cardiovascular ...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0115/od1.html

Risk Assessment for Cardiovascular Disease with Nontraditional Risk Factors - Putting ...

Jan 15, 2019 - A 46-year-old Asian American woman with no significant medical history presents to your clinic for the first time for a pre-employment physical examination.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0115/p123.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.html

Cardiac Rehabilitation - American Family Physician

Nov 1, 2009 - An estimated 80 million (nearly one in three) Americans have cardiovascular disease, which is the leading cause of morbidity and mortality worldwide. In the United States alone, more than 850,000 deaths are attributed annually to cardiovascular disease, and more than 8 million Americans...

American Family Physician : Article

https://www.aafp.org/afp/2009/1101/p955.html

Aspirin’s Benefits and Harms Are Less Clear for Primary Prevention in Moderate-Risk ...

Apr 1, 2019 - In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459a.html

Diets for Cardiovascular Disease Prevention: What Is the Evidence? - American Family ...

Apr 1, 2009 - Patients often initiate commercial dietary plans to reduce obesity and prevent cardiovascular disease. Such plans include very low-carbohydrate, low-carbohydrate, very low-fat, and Mediterranean diets. Published evidence on several popular diets has made it easier for physicians to ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0401/p571.html

Screening for Cardiovascular Disease Risk with Electrocardiography: Recommendation ...

Sep 15, 2018 - The USPSTF recommends against screening with resting or exercise electrocardiography (ECG) to prevent cardiovascular disease (CVD) events in asymptomatic adults at low risk of CVD events.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2018/0915/od1.html

Overuse of Cardiac Testing - Lown Right Care: Reducing Overuse and Underuse - American ...

Nov 15, 2018 - This is the first of a new collaboration between AFP and the Lown Institute. This new feature promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2018/1115/p561.html

Early Invasive Management of Acute Coronary Syndromes - Medicine by the Numbers - ...

Dec 1, 2018 - Does early invasive management help patients with unstable angina or acute non–ST-segment elevation myocardial infarction (NSTEMI) in reducing occurence of death, myocardial infarction, angina symptoms, and rehospitalization at six- to 12-month follow-up? Find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1201/od1.html

Hormone Therapy for Primary Prevention of Cardiovascular Disease in Postmenopausal ...

Oct 1, 2018 - No benefit was observed in postmenopausal women receiving hormone therapy for primary prevention of cardiovascular disease. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1001/od1.html

Statins Effective for LDL 190 mg per dL or Higher, Regardless of Risk Level - POEMs - ...

Jul 1, 2018 - These results confirm that the use of statins for men with an LDL cholesterol level of at least 190 mg per dL, regardless of calculated risk, is associated with a clinically and statistically significant reduction in cardiovascular events and probably cardiovascular and all-cause ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p54a.html

Diagnosis of Acute Coronary Syndrome - FPIN's Help Desk Answers - American Family ...

Aug 1, 2018 - The best test to diagnose ACS is a risk score based on a clinical prediction rule such as the HEART (history, electrocardiography, age, risk factors, troponin level) or TIMI (Thrombolysis in Myocardial Infarction) risk score, which have positive likelihood ratios (LR+'s) of 13 and 6.8, ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0801/od2.html

Screening for Cardiovascular Disease Risk with Electrocardiography - Putting Prevention...

Sep 15, 2018 - A 55-year-old man presents for an annual visit. He has no history of hypertension, cardiovascular disease (CVD), or diabetes mellitus; has never smoked; and has no family history of CVD. His lipid panel results from one year ago were normal, and he has no current symptoms of CVD.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0915/p375.html

Syncope Evaluation and Treatment Guidelines from ACC, AHA, and HRS - Practice ...

Apr 1, 2018 - The American College of Cardiology (ACC), American Heart Association (AHA), and Heart Rhythm Society (HRS) have released guidelines to assist physicians in evaluating and treating syncope.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0401/p478.html

Febuxostat Increases All-Cause and Cardiovascular Mortality Compared with Allopurinol -...

Sep 15, 2018 - For patients with gout who require treatment to lower their uric acid level, allopurinol is a safer option than febuxostat.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p385.html

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults - Putting ...

Dec 15, 2017 - L.D., a 66-year-old generally healthy white man, presents for his annual physical. He has no history of cardiovascular disease (CVD); he has had consistent systolic blood pressure measurements of 140 mm Hg; he is not taking any medications; he does not smoke; he exercises three times ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/1215/p805.html

PCI Equal to Sham PCI for Exercise Tolerance in Patients with Stable Angina Plus Severe...

Jul 1, 2018 - In patients with stable angina and severe coronary artery disease (CAD), PCI plus optimal medical treatment does not improve exercise tolerance or angina more than sham PCI plus optimal medical treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p55.html

Omega-3 Fatty Acids and Cardiovascular Disease - Implementing AHRQ Effective Health ...

May 1, 2018 - What is the effect of omega-3 fatty acid supplementation on cardiovascular outcomes?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2018/0501/p562.html

Use of Niacin for Primary or Secondary Prevention of Cardiovascular or Cerebrovascular ...

Apr 1, 2018 - Prescription niacin (nicotinic acid, vitamin B3) does not reduce myocardial infarctions, strokes, or overall mortality when used for primary or secondary prevention.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0401/p436.html

High-Sensitivity Troponin I of Less Than 5 ng per L Has Negative Predictive Value of ...

Mar 15, 2018 - A cardiac troponin I concentration of less than 5 ng per L in adults who present with potential acute coronary syndrome has a negative predictive value (NPV) of at least 99.9% for cardiac death at 30 days and at one year.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p410.html

Estimating Cardiovascular Risk - Point-of-Care Guides - American Family Physician

May 1, 2017 - The primary prevention of cardiovascular disease (CVD) depends on accurate estimation of cardiovascular risk. However, a recent systematic review identified 363 prediction models.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/0501/p580.html

No Effect on Mortality with Oxygen Therapy in Nonhypoxemic Patients with Suspected MI -...

Feb 15, 2018 - In patients with suspected MI and normal oxygen levels, giving immediate supplemental oxygen therapy does not improve mortality at one year. Although this study was underpowered because of fewer than expected deaths in the control group, the results were consistent across all subgroups,...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od3.html

Stents for Stable Coronary Artery Disease - Medicine by the Numbers - American Family ...

Jan 1, 2018 - Most published trials fail to show a benefit from coronary stenting in patients with stable obstructive coronary artery disease. However, stent technology has evolved significantly in recent years, and it is possible that newer-generation drug-eluting stents may offer different results.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0101/od1.html

Diagnosis of Acute Coronary Syndrome - American Family Physician

Jul 1, 2005 - The term 'acute coronary syndrome' encompasses a range of thrombotic coronary artery diseases, including unstable angina and both ST-segment elevation and non-ST-segment elevation myocardial infarction. Diagnosis requires an electrocardiogram and a careful review for signs and symptoms ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0701/p119.html

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for ...

Nov 15, 2017 - The USPSTF recommends that primary care professionals individualize the decision to offer or refer adults without obesity who do not have hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes to behavioral counseling to promote a healthful diet and physical activity.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2017/1115/od2.html

Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with...

Dec 15, 2018 - << Previous article Next article >> Dec 15, 2018 Issue Putting Prevention into Practice An Evidence-Based Approach Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with the Ankle-Brachial Index JUSTIN MILLS, MD, MPH, U.S. Preventive Services Task...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/1215/p754.html

Prolonged Dual Antiplatelet Therapy After MI Reduces Major Adverse Cardiac Events - ...

Oct 1, 2017 - In patients who are stable one year post-MI, prolonged use of dual antiplatelet therapy may be an effective treatment to decrease major cardiac events and cardiovascular mortality.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1001/od1.html

In Very High-Risk Patients with Vascular Disease, Evolocumab Slightly Reduces Nonfatal ...

Oct 1, 2017 - In an extremely high-risk group of patients with known vascular disease, taking evolocumab instead of placebo in addition to standard statin therapy for slightly more than two years will prevent one myocardial infarction (MI) for every 83 persons treated and prevent one stroke for every...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1001/p470.html

More Accurate Prediction of the Pretest Probability of Cardiovascular Disease with ...

May 15, 2017 - The European approach to determining the pretest likelihood of coronary artery disease (CAD) in patients with chest pain is superior to that of the Diamond-Forrester approach recommended by U.S. guidelines, and will result in less need for immediate invasive treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0515/od1.html

Niacin Does Not Decrease Mortality in Patients with Coronary Artery Disease or Low HDL ...

Jul 15, 2017 - We are now flush with data about the effects of niacin in patients with elevated cholesterol levels. Despite its ability to raise high-density lipoprotein (HDL) serum cholesterol levels, it does not add additional mortality or morbidity benefit to statin treatment. Patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p129.html

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer:...

Oct 15, 2016 - The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at ...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2016/1015/od1.html

The Cholesterol Dilemma: Treating the Risk or Treating to LDL-C Goal? - Editorials - ...

Jan 15, 2017 - Statins will long remain the cornerstone of treatment because of their proven benefits and cost-effectiveness, especially in the four statin benefit groups. However, emerging RCT evidence shows that the degree of LDL-C lowering may be more important than the drug used to achieve it.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0115/p66.html

Radiologic Evaluation of Acute Chest Pain—Suspected Myocardial Ischemia - American ...

Aug 15, 2007 - The American College of Radiology has developed appropriateness criteria for a number of clinical conditions and procedures. Criteria are available on imaging tests used in the evaluation of acute chest pain--suspected myocardial ischemia. Imaging tests for a suspected cardiac etiology ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0815/p533.html

PCI Has More Benefits and Harms Than CABG for Selected Patients with Left Main Coronary...

Apr 1, 2017 - Patients undergoing PCI had fewer early myocardial infarctions, but more later deaths and later myocardial infarctions. There are other benefits to PCI, including shorter hospital stay, lower cost, and faster recovery. But patients should be informed of the tradeoffs, and it is ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p455a.html

Aspirin for the Prevention of Cardiovascular Disease and Colorectal Cancer: New ...

Feb 15, 2017 - In April 2016, the U.S. Preventive Services Task Force (USPSTF) updated its recommendation on the use of aspirin to prevent cardiovascular disease (CVD). Because emerging evidence suggested that aspirin may also be useful for the prevention of cancer, for the first time, the USPSTF ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0215/p222.html

Semaglutide Reduces CV Events in High-Risk Patients with Type 2 Diabetes Mellitus - ...

Mar 15, 2017 - Semaglutide significantly reduced the composite outcome of CV death, nonfatal myocardial infarction, and nonfatal stroke (number needed to treat [NNT] = 43 over 2.1 years). It was generally well tolerated, and it reduced body weight by approximately 6.4 to 9.5 lb (2.9 to 4.3 kg).

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/p396.html

Detrimental Effect of Tight Glucose Control on CV Mortality Persists Over Nine Years - ...

Mar 15, 2017 - The initial Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which compared standard treatment with intensive control, found that despite good intentions, cardiovascular (CV) and overall mortality are significantly higher when blood glucose levels are lower.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od2.html

Preparation of the Cardiac Patient for Noncardiac Surgery - American Family Physician

Mar 1, 2007 - Approximately 20 to 40 percent of patients at high risk of cardiac-related morbidity develop myocardial ischemia perioperatively. The preferred approach to diagnostic evaluation depends on the interactions of patient-specific risk factors, surgery-specific risk factors, and exercise ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0301/p656.html

Ordering and Understanding the Exercise Stress Test - American Family Physician

Jan 15, 1999 - The exercise stress test is a useful screening tool for the detection of significant coronary artery disease. Documentation of the patient's symptoms, medications, past and current significant illnesses, and usual level of physical activity helps the physician determine if an exercise ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0115/p401.html

Noninvasive Cardiac Imaging - American Family Physician

Apr 15, 2007 - Noninvasive cardiac imaging can be used for the diagnostic and prognostic assessment of patients with suspected or known coronary artery disease. It is central to the treatment of patients with myocardial infarction, coronary artery disease, or acute coronary syndromes with or without ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0415/p1219.html

In Patients with Vascular Disease, Treating Sleep Apnea Does Not Reduce the Risk of ...

Jan 15, 2017 - Compared with usual care, the use of CPAP provides a modest improvement in daytime sleepiness, but does not reduce the likelihood of cardiovascular events, even in a high-risk population.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0115/p123.html

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer ...

Oct 15, 2016 - S.L. is a 55-year-old man who presents to your office for a routine refill of his antihypertension medication. He also takes a statin and an antidepressant. Although he smokes, his blood pressure and cholesterol are well controlled. His history and physical examination are unremarkable.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/1015/p661.html

The Risk of MI and Ischemic Stroke with Combined Oral Contraceptives - Cochrane for ...

Nov 1, 2016 - The overall risk of MI and ischemic stroke is increased in women who use combined oral contraceptives. The relative risk of MI and ischemic stroke increases as estrogen dose rises, increasing by 60% with doses of 20 mcg and more than doubling when doses of 50 mcg or more are used.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1101/p691.html

Impact of Exercise-Based Cardiac Rehabilitation - Cochrane for Clinicians - American ...

Dec 1, 2016 - Exercise-based cardiac rehabilitation reduces cardiovascular mortality and hospitalization. There is no evidence that it reduces the rates of total mortality, myocardial infarctions, coronary artery bypass grafts, or percutaneous coronary interventions.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1201/p881.html

Update on Exercise Stress Testing - American Family Physician

Nov 15, 2006 - Exercise stress testing is an important diagnostic tool for the evaluation of suspected or known cardiac disease. In 2002, the American College of Cardiology (ACC) and the American Heart Association (AHA) revised their guidelines for exercise testing. Ten categories from the ACC/ AHA ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1115/p1749.html

Rapid Protocols to Rule out Myocardial Infarction - Point-of-Care Guides - American ...

Jun 15, 2016 - Cardiac troponin T and I are released into the bloodstream when cardiac muscle is damaged. Cardiac troponin tests have been available for decades and are the preferred biomarkers for the diagnosis of acute myocardial infarction (AMI). However, until recently, they lacked sensitivity in ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/0615/p1008.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

Vascular Surgery: An Update - American Family Physician

Jan 1, 2007 - Caring for patients with vascular illnesses has become increasingly more complex and has changed dramatically over the past 10 years, with a widening array of diagnostic and treatment options. Carotid artery stenting has the potential to become a viable alternative to open surgery in ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0101/p85.html

Preventing Cardiovascular Disease in Women - American Family Physician

Oct 15, 2006 - Cardiovascular disease (CVD) has been the primary cause of death in women for almost a century, and more women than men have died of CVD every year since 1984. Although CVD incidence can be reduced by adherence to a heart-healthy lifestyle and detection and treatment of major risk ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1015/p1331.html

Low High-Sensitivity Troponin I Level Accurate in Identifying Patients at Low Risk of ...

Apr 15, 2016 - The high-sensitivity troponin I assay used in this study was fairly accurate in identifying patients with chest pain who are at low risk of cardiac events.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0415/p704a.html

Preventing CVD in Adults with Type 2 Diabetes Mellitus: An Update from the AHA and ADA ...

Feb 1, 2016 - The American Heart Association (AHA) and American Diabetes Association (ADA) joined together to release statements on preventing CVD in persons with diabetes.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0201/p232.html

Nutritional Assessment and Counseling for Prevention and Treatment of Cardiovascular ...

Jan 15, 2006 - Physicians face several barriers to counseling their patients about nutrition, including conflicting evidence of the benefit of counseling, limited training and understanding of the topic, and imperfect and varied guidelines to follow. Because cardiovascular disease remains the leading ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0115/p257.html

More Nuanced Guidelines for Lipid Lowering to Prevent CVD - POEMs - American Family ...

Jan 1, 2016 - The authors of this guideline give a more nuanced and less aggressive approach to lipid lowering than other groups. For the primary prevention of CVD, check blood pressure and lipids (nonfasting is fine) to calculate the 10-year CVD risk. If greater than 12%, treat; if 12% or less, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0101/p59.html

CCTA and Radionuclide Stress Testing Similar for Evaluation of Chest Pain - POEMs - ...

Dec 1, 2015 - For the evaluation of chest pain in intermediate-risk patients, CCTA is comparable with myocardial perfusion imaging in its ability to select patients for invasive management. Both modalities are also similar when it comes to downstream resource use and adverse cardiovascular events. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1022.html

CT Coronary Angiography in Patients with Suspected CAD: No Short-Term Benefit, ...

Nov 15, 2015 - For patients with suspected stable CAD, adding CT coronary angiography had no short-term effect on patient symptoms or hospitalizations but increased the number of coronary angiograms. Additionally, more patients who had CT coronary angiography underwent preventive treatment and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1115/p928.html

ECG, Echocardiography, or MPI for Cardiac Screening: Guidance from the ACP - Practice ...

Sep 15, 2015 - In the United States, one in three deaths is from cardiovascular disease; coronary heart disease is the leading cause of death. This guideline from the American College of Physicians (ACP) provides recommendations on cardiac screening using these modalities.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0915/p531.html

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for ...

Sep 15, 2015 - J.W., a 34-year-old man who smokes, presents for his annual checkup for hypertension. Hisblood pressure is elevated (142/95 mm Hg), and he has gained 10 lb (4.5 kg) since his lastvisit. J.W. is now considered overweight, with a body mass index (BMI) of 27 kg per m2. He reports no other ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2015/0915/p509.html

Management of Non-ST Elevation Acute Coronary Syndrome: A Guideline from the AHA and ...

Jul 15, 2015 - Acute coronary syndrome (ACS), a term that encompasses a range of conditions, is caused when blood flow to the heart is suddenly reduced. The American College of Cardiology (ACC), with the American Heart Association (AHA), has provided recommendations for managing non–ST elevation ACS.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0715/p151.html

Vorapaxar (Zontivity) for the Prevention of Thrombotic Cardiovascular Events - STEPS - ...

Aug 15, 2015 - Vorapaxar should be limited to select patients with a history of MI or peripheral arterial disease who desire additional treatment for the prevention of MI.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0815/p304.html

Omega-3 Fatty Acids - American Family Physician

Jul 1, 2004 - Omega-3 fatty acids have been shown to significantly reduce the risk for sudden death caused by cardiac arrhythmias and all-cause mortality in patients with known coronary heart disease. Fatty fish, such as salmon and tuna, and fish oil are rich sources of the omega-3 fatty acids ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0701/p133.html

Two-Hour Algorithm to Rule In or Rule Out Acute MI - POEMs - American Family Physician

Aug 1, 2015 - A simple rule (see synopsis) using high-sensitivity cardiac troponin levels measured on presentation and two hours later is an effective way to identify patients with or without MI. This rule was developed in one group of patients and validated in a second group. At a prevalence of 9%, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0801/p228a.html

NSAID Use Associated with Increased Risk of Serious Bleeding and CV Events After MI - ...

Jul 1, 2015 - The use of concomitant NSAIDs in adults who receive antithrombotic therapy after MI increases the risk of serious bleeding complications and recurrent adverse CV events. This study found the highest risk among users of celecoxib (Celebrex) and diclofenac, and the lowest risk among users...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p60.html

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for ...

May 1, 2015 - The USPSTF recommends offering or referring adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2015/0501/od1.html

Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of ...

Jan 1, 2015 - The U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of multivitamins for the prevention of cardiovascular disease or cancer.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2015/0101/od1.html

No Benefit to Screening with CTA for Asymptomatic CAD in Adults with Diabetes - POEMs -...

Apr 15, 2015 - Using coronary CTA to screen for CAD in adults with type 1 or type 2 diabetes and no indication of existing CAD does not improve outcomes more than standard care.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0415/p566.html

Post-Myocardial Infarction Beta Blockers Do Not Decrease Mortality - POEMs - American ...

Mar 15, 2015 - Although recommended by guidelines and used as a so-called quality indicator of hospital care, the use of beta blockers following myocardial infarction, when combined with optimal acute and chronic treatment, does not provide a further survival benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0315/p402a.html

Low-Carbohydrate Diet Better Than Low-Fat Diet to Reduce Cardiovascular Risk Factors ...

Feb 15, 2015 - More than 40 years ago, Dr. Robert Atkins wrote his first book advocating for a low-carbohydrate diet to cause and sustain weight loss. This study (of mostly women) found that a low-carbohydrate diet—though not as severe a diet as the Atkins approach—caused an average 3.5 kg (7.7 lb) ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0215/p262.html

Increasing HDL Level Ineffective at Decreasing Cardiovascular Events - POEMs - American...

Jan 15, 2015 - Being the good cholesterol is not the same as being the useful cholesterol. Drug therapy aimed at increasing HDL cholesterol levels, when added to statin treatment, does not decrease patients' likelihood of experiencing a cardiovascular event or of dying earlier.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0115/p133.html

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