Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, US.
Houston Methodist Hospital, Houston, Texas, US.
Methodist Debakey Cardiovasc J. 2021 Sep 24;17(4):79-86. doi: 10.14797/mdcvj.907. eCollection 2021.
Compelling results from clinical trials supporting intensive risk-reduction therapies to reduce associated morbidity and mortality in patients with established atherosclerotic cardiovascular disease (ASCVD) provided the impetus for medical societies to integrate these evidence-based results into clinical practice guidelines. Current evidence, however, points toward gaps in the management of patients with established ASCVD. Some of these gaps are related to barriers to guideline implementation, and strategies are needed to overcome these barriers. In this review, we propose a framework incorporating comprehensive tools for enhanced guideline-directed management in secondary prevention of ASCVD. This aid includes a 13-point checklist with supporting educational and system-based tools for effective evidence-based pharmacological and nonpharmacological care. This proposed tool targets primary care providers and cardiologists in the outpatient setting who provide direct medical care for patients with established ASCVD.
支持强化风险降低治疗的临床试验结果令人信服，这些治疗可降低已确诊动脉粥样硬化性心血管疾病 (ASCVD)患者的相关发病率和死亡率，这为医学协会将这些基于证据的结果纳入临床实践指南提供了动力。然而，目前的证据表明，在已确诊 ASCVD 患者的管理方面存在一些差距。其中一些差距与指南实施的障碍有关，需要采取策略来克服这些障碍。在这篇综述中，我们提出了一个框架，纳入了用于增强 ASCVD 二级预防中指南指导管理的综合工具。该辅助工具包括一个 13 点清单，以及支持有效循证药物和非药物治疗的教育和基于系统的工具。该工具针对的是在门诊环境中为已确诊 ASCVD 患者提供直接医疗服务的初级保健提供者和心脏病专家。
