Chapter

Subsequent management

Samir Srivastava and Gregory YH Lip

in Acute Coronary Syndromes

Published on behalf of Oxford University Press

ISBN: 9780199543496
Published online May 2011 | e-ISBN: 9780199607198 | DOI: http://dx.doi.org/10.1093/med/9780199543496.003.0006

Series: Oxford Cardiology Library

Subsequent management

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Acute coronary syndrome patients have a high risk of recurrence of an ischaemic event. Appropriate secondary prevention measures should be taken. Aggressive risk factor management and pharmacotherapy can reduce the need for further percutaneous coronary interventional procedures. Dual anti-platelet therapy is usually continued for up to 12 months (unless being considered for coronary artery bypass grafting); one agent remains life-long. ACE inhibitors have an anti-atherogenic effect and should be used in patients with established atherosclerotic disease. Blood pressure should ideally be less than 140/90 mmHg (130/80 in diabetics). It is essential to address all lifestyle issues. Subsequent PCI can be useful for alleviating cardiac ischaemic symptoms, but does not confer a mortality benefit and is not a superior strategy compared with medical therapy.

Chapter.  2818 words.  Illustrated.

Subjects: Cardiovascular Medicine

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