Treatment
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Smoking Cessation Counseling
Î Smoking cessation and avoidance of exposure to environmental
tobacco smoke at work and home should be encouraged for all
patients with SIHD. Follow-up, referral to special programs, and
pharmacotherapy are recommended, as is a stepwise strategy for
smoking cessation (Ask, Advise, Assess, Assist, Arrange, Avoid). (I-B)
Management Of Psychological Factors
Î It is reasonable to consider screening SIHD patients for depression
and to refer or treat when indicated. (IIa-B)
Î Treatment of depression has not been shown to improve
cardiovascular disease outcomes but might be reasonable for its other
clinical benefits. (IIb-C)
Alcohol Consumption
Î In patients with SIHD who use alcohol, it might be reasonable for
nonpregnant women to have 1 drink (4 ounces of wine, 12 ounces of
beer, or 1 ounce of spirits) a day and for men to have 1 or 2 drinks
a day, unless alcohol is contraindicated (such as in patients with a
history of alcohol abuse or dependence or with liver disease). (IIb-C)
Avoiding Exposure To Air Pollution
Î It is reasonable for patients with SIHD to avoid exposure to increased
air pollution to reduce the risk of cardiovascular events. (IIa-C)
Antiplatelet Therapy
Î Treatment with aspirin 75-162 mg daily should be continued
indefinitely in the absence of contraindications in patients with SIHD.
(I-A)
Î Treatment with clopidogrel is reasonable when aspirin is
contraindicated in patients with SIHD. (I-B)
Î Treatment with aspirin 75-162 mg daily and clopidogrel 75 mg daily
might be reasonable in certain high-risk patients with SIHD. (IIb-B)
Î Dipyridamole is NOT recommended as antiplatelet therapy for
patients with SIHD. (III-B: No Benefit)
