November 4th, 2011
AHA and ACC Update Secondary Prevention Guidelines
Larry Husten, PHD
The AHA and ACC have released an update of their guidelines for secondary prevention in patients with heart disease. The guidelines are available in Circulation and the Journal of the American College of Cardiology.
The updated guidelines place a new emphasis on cardiac rehabilitation for patients who have had an MI or CABG. They also stress the importance of diagnosing and treating depression in patients with heart disease. In addition, the guidelines now recommend ticagrelor and prasugrel as well as clopidogrel in addition to aspirin for stent patients.
In anticipation of new guidelines next year from the NHLBI, the guidelines do not include new recommendations regarding blood pressure or cholesterol.
When it comes to low dose aspirin, my understanding was that the bioavailability of an enteric formulation is lower than the uncoated version. But this consideration does not appear in the guidelines. I use either 81 mg uncoated or 162in mg coated.