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Stable ischemic heart disease management: clinical guideline

Clinical Question:
What are the recommendations for managing patients with suspected ischemic heart disease?

Bottom Line:
Little has changed regarding the medical management of patients with stable ischemic heart disease, reserving revascularization for patients at substantial risk and those who have symptoms despite optimized medical therapy. (LOE = 5)

Reference:
Qaseem A, Fihn SD, Williams S, et al, for the Clinical Guidelines Committee of the American College of Physicians. Management of stable ischemic heart disease: Summary of a clinical practice guideline from the American College of Physicians/American College of Cardiology Foundation/American Heart Association/American Association for Thoracic Surgery/Preventive Cardiovascular Nurses Association/Society of Thoracic Surgeons. Ann Intern Med 2012;157(10):735-743.  [PMID:23165665]

Study Design:
Practice guideline

Funding:
Unknown/not stated

Setting:
Various (guideline)

Synopsis:
This guideline statement, issued by several US societies, presents 48 recommendations. Some of the recommendations seem to lag behind current evidence; a low cholesterol diet, for example. On the other hand, the guidelines no longer recommend homocysteine-lowering treatment with B vitamins, or antioxidant treatment with vitamin E or beta-carotene. The rest of the guidelines are similar to established practices. The guideline statement is available free of charge at http://annals.org/article.aspx?articleid=1392195.

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