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.