Optimal medical management of coronary artery disease

Abstract

• The goals of management for coronary artery disease are two-fold: to reduce the risk of death and myocardial infarction, and to reduce symptoms of angina and the occurance of ischaemia. • All patients with coronary artery disease should be screened for diabetes, which is often unmasked during a presentation with an acute coronary syndrome. All diabetic patients with proteinuria should be treated with an ACE inhibitor. • Antiplatelet agents have unequivocal benefits in coronary artery disease. Unless contraindicated, aspirin should be used indefinitely by most patients who have known cardiovascular disease. • ACE inhibition should be considered in all coronary artery disease patients. • Patient education is often neglected in the management of patients with coronary artery disease. Explanations about recognising symptoms that can be suggestive of acute myocardial infarction are particularly important.