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4.2.5. Sexual Health and Activity
COR LOE
Recommendations
2a B-NR 1. In patients with CCD, it is reasonable to individualize
resumption of sexual activity based on type of sexual
activity, exercise capacity, and postprocedural healing.*
2a B-NR 2. In patients with CCD, cardiac rehabilitation and regular
exercise can be useful to reduce the risk of cardiovascular
complications with sexual activity.*
3: Harm B-NR 3. In patients with CCD, phosphodiesterase type 5 inhibitors
should not be used concomitantly with nitrate medications
because of risk for severe hypotension.*
* Modified from the 2012 AHA scientific statement on sexual activity and CVD. Levine GN,
et al. Circulation. 2012;125:1058-1072.
4.2.6. Lipid Management
COR LOE
Recommendations
1 A 1. In patients with CCD, high-intensity statin therapy is
recommended with the aim of achieving a ≥50% reduction
in LDL-C levels to reduce the risk of MACE.*
1 A 2. In patients in whom high-intensity statin therapy is
contraindicated or not tolerated, moderate-intensity statin
therapy is recommended with the aim of achieving a 30%
to 49% reduction in LDL-C levels to reduce the risk of
MACE.*
1 A 3. In patients with CCD, adherence to changes in lifestyle
and effects of lipid-lowering medication should be assessed
by measurement of fasting lipids in 4 to 12 weeks after
statin initiation or dose adjustment and then every 3 to
12 months thereafter based on need to assess response or
adherence to therapy.*
Cost Value
Statement:
High
Value
B-NR 4. In patients with CCD, the use of generic formulations of
maximally tolerated statin therapy is projected to be cost
saving.
2a B-R 5. In patients with CCD who are judged to be at very
high risk (Table 10) and on maximally tolerated statin
therapy with an LDL-C level ≥70 mg/dL (≥1.8 mmol/L),
ezetimibe can be beneficial to further reduce the risk of
MACE.*
