CAD Therapy - white

In patient with CCD and angina ___ recommended

Beta Blocker, CCB, or long-acting nitrate

if patient has angina and is on Beta Blocker, CCB, or long-acting nitrate and still symptomatic

add agent from diff therapeutic class, add ranolazine, use SL nitroglycerin (relief)

• Effective in patients with CCD, especially those with recent MI and those with ongoing angina, given their ability to reduce angina, improve angina-free exercise tolerance, reduce exertion-related myocardial ischemia, and reduce risk of CVD events

• LVEF <40%

BB

Protection against severe angina, reduce risk of reinfarction after MI

• ___ have not shown survival benefit after MI like beta blocker 

CCBs

not be combined with BB

Non-ccb

• Avoid abrupt withdrawal due to rebound phenomenon → risk of AMI and sudan death

  • Taper over 1-3 weeks

BB

due to vasodilation and systemic hypotension → headache, dizziness, palpitations, flushing; peripheral edema

• CYP3A4 interactions with drugs such as carbamazepine, cyclosporine, lithium, amiodarone, digoxin

CCB

For those with SIHD who not tolerate beta blockers, calcium channel blockers, or long-acting nitrates, or they are not adequately effective

• May be used in combo or as substitute 

Ranolazine

For those with SIHD as initial therapy for symptom relief

Long-acting nitrates

Those with SIHD, for short-term immediate relief of angina

Short-acting nitrates

In patients with CCS who have undergone elective PCI and who need anticoag therapy, ___, for 1-4 weeks followed by clopidogrel alone for 6 months should be admin in addition to DOAC

DAPT

For those with SIHD who also have HTN, diabetes, LVEF<40% or less, or CKD

Ace, arb if intolerble

If GDMT doesn’t work there are recommendations for diagnostic testing, invasive coronary angiography is an option