{"id":44379,"date":"2014-07-30T08:23:42","date_gmt":"2014-07-30T12:23:42","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=44379"},"modified":"2014-07-30T08:23:42","modified_gmt":"2014-07-30T12:23:42","slug":"heart-groups-update-guidelines-on-stable-ischemic-heart-disease","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2014\/07\/30\/heart-groups-update-guidelines-on-stable-ischemic-heart-disease\/","title":{"rendered":"Heart Groups Update Guidelines on Stable Ischemic Heart Disease"},"content":{"rendered":"<div id=\"stcpDiv\">\n<p id=\"p-3\">The American College of Cardiology and the American Heart Association have issued a<a href=\"http:\/\/content.onlinejacc.org\/article.aspx?articleID=1891717\"> focused update<\/a> to their 2012 guideline on diagnosing and managing patients with stable ischemic heart disease (IHD).<\/p>\n<p id=\"p-4\">The update, published in the <em>Journal of the College of Cardiology<\/em>, includes a new section on the role of invasive coronary angiography for the diagnosis of coronary artery disease (CAD) in patients with suspected stable IHD. Angiography is:<\/p>\n<ul id=\"list-1\">\n<li id=\"list-item-1\">\n<p id=\"p-5\">&#8220;useful&#8221; in patients with presumed stable IHD who continue to have &#8220;unacceptable&#8221; symptoms despite guideline-directed medical therapy and who are open to, and eligible for, coronary revascularization;<\/p>\n<\/li>\n<li id=\"list-item-2\">\n<p id=\"p-6\">&#8220;reasonable&#8221; to determine the extent of CAD in patients with suspected stable IHD who have a high likelihood of severe IHD based on clinical characteristics and noninvasive testing;<\/p>\n<\/li>\n<li id=\"list-item-3\">\n<p id=\"p-7\">&#8220;reasonable&#8221; in those with suspected symptomatic stable IHD who cannot undergo diagnostic stress testing when it&#8217;s likely that the findings will warrant &#8220;important changes to therapy.&#8221;<\/p>\n<\/li>\n<\/ul>\n<p id=\"p-8\">In addition, the groups now say that chelation is of uncertain value in reducing cardiovascular events in patients with stable IHD (the 2012 guideline said chelation was not recommended), and a heart team approach to revascularization is now advised for patients with diabetes and multivessel CAD.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>The American College of Cardiology and the American Heart Association have issued a focused update to their 2012 guideline on diagnosing and managing patients with stable ischemic heart disease (IHD). The update, published in the Journal of the College of Cardiology, includes a new section on the role of invasive coronary angiography for the diagnosis [&hellip;]<\/p>\n","protected":false},"author":577,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-44379","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/44379","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/577"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=44379"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/44379\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=44379"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=44379"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=44379"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}