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Chronic Coronary Disease 2023

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49 Linked Pharmacotherapy Baseline therapy: If atherosclerosis or endothelial impairment, patients should be considered for aspirin, statin, and ACEi. Consideration of revascularization, antianginal therapy as per guidelines Cessation of antianginal therapy. Stop antiplatelet and statins unless other indication. Consider noncardiac investigation or referral where appropriate (eg, psycholog y, gastroenterolog y) 6.2. CAD With Valvular Heart Disease ➤ Concurrent CCD is common in patients with valvular heart disease. The evaluation and management of CCD at the time of valve intervention is discussed in the "2021 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease." After valve intervention, patients with valvular heart disease and concomitant CCD should be managed according to current recommendations for secondary prevention as outlined in this guideline. Patients with severe aortic stenosis and concomitant CCD who undergo PCI and transcatheter aortic valve implantation should be treated with DAPT according to the 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization. 6.3. Young Adults COR LOE Recommendation 2a C-LD 1. In young adults with CCD, after optimization of traditional cardiovascular risk factors, a comprehensive evaluation and treatment of nontraditional cardiovascular risk factors can be beneficial in reducing the risk of cardiovascular events.

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