冠心病CBL课前学习材料2.pdf

7. Lifestyle and pharmacological management 7.1 Risk factors and ischaemia management 7.1.1 General management of stable coronary artery disease patients The aim of the management of SCAD is to reduce symptoms and improve prognosis. The management of CAD patients encompasses lifestyle modification, control of CAD risk factors, evidence-based pharmacological therapy and patient education. Lifestyle recommendations are described in recent ESC guidelines. 7.1.2 Lifestyle modifications and control of risk factors 7.1.2.1 Smoking Smoking is a strong and independent risk factor for CVD and all smoking, including environmental smoking exposure, must be avoided in all patients with CVD. The benefits of smoking cessation have been extensively reported, and quitting smoking is potentially the most effective of all preventive measures, being associated with a reduction in mortality of 36% after MI. Clinicians treating patients with CAD can take advantage of the unique situation and emphasize that the risk of future CAD events can be dramatically reduced by smoking cessation. Thus, smoking status should be assessed systematically (including passive smoking) and all smokers should be advised to quit and offered cessation assistance. Quitting smoking is complex because smoking is both pharmacologically and psychologically highly addictive. Advice, encouragement and pharmacological aid consistently improve success rates. Nicotine replacement therapy is safe in patients with CAD and should routinely be offered. Bupropion and varenicline have been found safe to use in patients with stable CAD in some studies, alt