Items in AFP with MESH term: Hydroxymethylglutaryl-CoA Reductase Inhibitors
Perioperative Cardiac Risk Reduction - Article
ABSTRACT: Cardiovascular complications are the most common cause of perioperative morbidity and mortality. Noninvasive stress testing is rarely helpful in assessing risk, and for most patients there is no evidence that coronary revascularization provides more protection against perioperative cardiovascular events than optimal medical management. Patients likely to benefit from perioperative beta blockade include those with stable coronary artery disease and multiple cardiac risk factors. Perioperative beta blockers should be initiated weeks before surgery and titrated to heart rate and blood pressure targets. The balance of benefits and harms of perioperative beta-blocker therapy is much less favorable in patients with limited cardiac risk factors and when initiated in the acute preoperative period. Perioperative statin therapy is recommended for all patients undergoing vascular surgery. When prescribed for the secondary prevention of cardiovascular disease, aspirin should be continued in the perioperative period.
Effective Therapies for Intermittent Claudication - FPIN's Clinical Inquiries
Adding ACE Inhibitors or ARBs to Standard Therapy for Stable Ischemic Heart Disease - Implementing AHRQ Effective Health Care Reviews
ABSTRACT: Interventions following a transient ischemic attack are aimed at preventing a future episode or stroke. Hypertension, current smoking, obesity, physical inactivity, diabetes mellitus, and dyslipidemia are all well-known risk factors, and controlling these factors can have dramatic effects on transient ischemic attack and stroke risk. For patients presenting within 48 hours of resolution of transient ischemic attack symptoms, advantages of hospital admission include rapid diagnostic evaluation and early intervention to reduce the risk of stroke. For long-term prevention of future stroke, the American Heart Association/American Stroke Association recommends antiplatelet agents, statins, and carotid artery intervention for advanced stenosis. Aspirin, extended-release dipyridamole/aspirin, and clopidogrel are acceptable first-line antiplatelet agents. Statins have also been shown to reduce the risk of stroke following transient ischemic attack, with maximal benefit occurring with at least a 50 percent reduction in low-density lipoprotein cholesterol level or a target of less than 70 mg per dL (1.81 mmol per L). For those with transient ischemic attack and carotid artery stenosis, carotid endarterectomy is recommended if stenosis is 70 to 99 percent, and perioperative morbidity and mortality are estimated to be less than 6 percent.