Skip to main content
SpringerLink
Log in

Drugs in the Primary and Secondary Prevention of Coronary Artery Disease

  • Reference work entry
  • First Online:
PanVascular Medicine

  • 189 Accesses

Abstract

The foundation for the prevention of coronary artery disease (CAD) is favorable modification of the risk factors of atherosclerosis. This is accomplished by lifestyle changes and, where necessary, pharmacological therapy. The latter comprises judicious use of evidence-based application of cardioprotective drugs. Multiple classes of these agents have been studied in controlled clinical trials which have provided convincing data for pharmacological primary and secondary prevention by reducing risk factors or modulating cardiac pathophysiology. The statin class of drugs is strongly advocated by the most recent prevention guidelines for the reduction of cardiovascular morbidity and mortality. However, in patients with elevated triglycerides and/or metabolic syndrome, evidence is unclear regarding the effects pharmacological therapy on prognosis. Beta-adrenergic blockers, inhibitors of the renin–angiotensin–aldosterone system (angiotensin-converting enzyme inhibitors [ACEI], angiotensin receptor blockers [ARBs], aldosterone inhibitors) improve survival and reduce recurrent MI in selected subgroups of myocardial infarction (MI) survivors. These classes of drugs also improve prognosis in selected patients with systolic cardiac dysfunction. The reduction of cardiovascular events has also been achieved in patients with hypertension by multiple drug classes, but beta-blockers are not recommended in the most recent hypertension guidelines because of absence of clear-cut evidence of benefit. Cessation of tobacco use is unequivocally advocated, but results of nondrug and drug methods are suboptimal. Influenza and pneumococcal vaccinations are recommended in patients with cardiac disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 649.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 549.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

Cholesteryl ester transfer protein (CETP) inhibitors:

A class of drugs that inhibit cholesteryl ester transfer protein (CETP) and improve lipids chiefly by raising serum concentration of HDL-C.

Peroxisome proliferator-activated receptor (PPAR) gamma agonists:

PPAR agonists are drugs which act upon the peroxisome proliferator-activated receptor and are used for the treatment of metabolic syndrome, lowering triglycerides and blood sugar.

Primary prevention:

Prevention of CVD and its complications in persons with no overt evidence of cardiovascular disease.

Proactive telephone-based counseling:

A system of telephone consultation to promote cigarette smoking cessation.

Secondary prevention:

Prevention of recurrent cardiac events in patients in whom cardiovascular disease has been previously documented.

ACCOMPLISH trial:

A clinical trial in which calcium channel blockers were superior to diuretics when added to ACE inhibitors in prevent cardiac events in high-risk patients.

ALLHAT study:

The results indicated that less costly, traditional diuretics were more effective than certain newer agents at lowering high blood pressure.

CAPRICORN trial:

In post-myocardial infarction patients with left ventricular dysfunction, long-term treatment with carvedilol reduced all-cause and cardiovascular mortality and recurrent, nonfatal myocardial infarctions.

COURAGE trial:

A prospective randomized trial of patients with angina and CAD that showed optimal medical therapy and PCI resulted in similar outcomes after a 5-year follow-up.

DAIS:

A clinical trial in which fenofibrate treatment was associated with reduced progression of coronary artery disease in patients with type 2 diabetes.

EUROPA trial:

A clinical trial in patients with stable coronary heart disease in which perindopril (an ACE inhibitor) improved outcomes.

FIELD study:

A clinical trial of patients with type 2 diabetes in which fenofibrate reduced total cardiovascular events, mainly due to fewer nonfatal myocardial infarctions and revascularizations.

Framingham Heart Study:

A major epidemiologic study from which much of our knowledge of cardiac risk factors has been derived.

Helsinki Heart Study:

A primary prevention trial in which gemfibrozil reduced improved serum lipids and was associated with a > 30 % reduction in cardiac events during a 5-year follow-up.

IDEAL study:

A cholesterol-lowering trial that employed atorvastatin and significantly reduced serum cholesterol and decreased cardiac events.

MRFIT study:

A 7-year multifactor cardiac risk intervention trial that resulted in risk factor reduction but no significant reduction in cardiac mortality in the intervention group; multiple explanations have been offered for this result.

National Cholesterol Education Program:

An educational program of the National Heart, Lung, and Blood Institute (NHLBI) to provide education and guidelines for the reduction of risk factors to decrease CVD.

NORDIL:

A clinical trial in hypertensive patients which reported that diltiazem was as effective as diuretics, beta-blockers, or both in preventing the combined primary end point of all stroke cases, myocardial infarctions, and other cardiovascular deaths.

ONTARGET study:

A clinical trial in patients with vascular disease or diabetes with end-organ damage in which ACE inhibitor (ramipril) and angiotensin receptor blocker (telmisartan) were evaluated for their effects on renal function and outcomes and which showed that telmisartan’s effects on major renal outcomes were similar to ramipril’s and combination therapy reduced proteinuria to a greater extent than monotherapy but overall it worsened renal outcomes.

PLATO study:

A clinical trial in which the platelet-inhibiting agent prasugrel was more effective in reducing cardiac events in patients with non-ST-elevation acute coronary syndrome than clopidogrel, albeit with more bleeding with prasugrel.

PTC (proactive telephone-based counseling):

A program of telephone sessions to help patients discontinue cigarette smoking.

SEARCH study:

A cholesterol-lowering trial with high- and low-dose simvastatin that showed high dose was more efficacious in lowering cholesterol and cardiac events.

Treat to New Targets (TNT) trial:

A cholesterol-lowering trial that employed atorvastatin and significantly reduced serum cholesterol and decreased cardiac events.

VA-HIT study:

A trial of men with CHD in which treatment with gemfibrozil was associated with a significant reduction in major cardiovascular events in patients whose primary lipid abnormality was low HDL cholesterol.

VALIANT:

A clinical trial in post-infarction patients in which it was shown that valsartan (an?angiotension receptor blocker) was as effective as captopril (ACE inhibitor) in reducing cardiac events but a combination of valsartan and captopril increased the rate of adverse events without improving survival.

β-Blocker Heart Attack Trial:

One of the earliest trials to show that beta-blocker therapy lowered mortality after myocardial infarction.

References

  • Ansquer JC, Foucher C, Rattier S, Taskinen MR, Steiner G, DAIS Investigators (2005) Fenofibrate reduces progression to microalbuminuria over 3 years in a placebo-controlled study in type 2 diabetes: results from the diabetes atherosclerosis intervention study (DAIS). Am J Kidney Dis 45:485–493

    Article  CAS  PubMed  Google Scholar 

  • Arai H, Hiro T, Kimura T, Morimoto T, Miyauchi K, Nakagawa Y, Yamagishi M, Ozaki Y, Kimura K, Saito S, Yamaguchi T, Daida H, Matsuzaki M, JAPAN-ACS Investigators (2010) More intensive lipid lowering is associated with regression of coronary atherosclerosis in diabetic patients with acute coronary syndrome – sub-analysis of JAPAN-ACS study. J Atheroscler Thromb 17:1096–1107

    Article  CAS  PubMed  Google Scholar 

  • Armitage J (2007) The safety of statins in clinical practice. Lancet 370:1781–1790

    Article  CAS  PubMed  Google Scholar 

  • Baber NS, Evans DW, Howitt G, Thomas M, Wilson T, Lewis JA, Dawes PM, Handler K, Tuson R (1980) Multicentre post-infarction trial of propranolol in 49 hospitals in the United Kingdom, Italy, and Yugoslavia. Br Heart J 44:96–100

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ballantyne CM, Nambi V (2004) Apolipoprotein A-I and high-density lipoproteins this the beginning of the era of noninvasive angioplasty?*. J Am Coll Cardiol 44:1436–1438

    CAS  PubMed  Google Scholar 

  • Bangalore S, Messerli FH, Cohen JD, Bacher PH, Sleight P, Mancia G, Kowey P, Zhou Q, Champion A, Pepine CJ, INVEST Investigators (2008a) Verapamil-sustained release-based treatment strategy is equivalent to atenolol-based treatment strategy at reducing cardiovascular events in patients with prior myocardial infarction: an INternational VErapamil SR-Trandolapril (INVEST) substudy. Am Heart J 156:241–247

    Article  CAS  PubMed  Google Scholar 

  • Bangalore S, Wild D, Parkar S, Kukin M, Messerli FH (2008b) Beta-blockers for primary prevention of heart failure in patients with hypertension: insights from a meta-analysis. J Am Coll Cardiol 52:1062–1072

    Article  CAS  PubMed  Google Scholar 

  • Barter PJ, Rye K-A (2008) Is there a role for fibrates in the management of dyslipidemia in the metabolic syndrome? Arterioscler Thromb Vasc Biol 28:39–46

    Article  CAS  PubMed  Google Scholar 

  • Bartolucci AA, Howard G (2006) Meta-analysis of data from the six primary prevention trials of cardiovascular events using aspirin. Am J Cardiol 98:746–750

    Article  CAS  PubMed  Google Scholar 

  • Berger JS, Roncaglioni MC, Avanzini F, Pangrazzi I, Tognoni G, Brown DL (2006) Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials. JAMA 295:306–313

    Article  CAS  PubMed  Google Scholar 

  • Berger JS, Brown DL, Becker RC (2008) Low-dose aspirin in patients with stable cardiovascular disease: a meta-analysis. Am J Med 121:43–49

    Article  CAS  PubMed  Google Scholar 

  • Bertrand ME, Ferrari R, Remme WJ, Simoons ML, Deckers JW, Fox KM (2010) Clinical synergy of perindopril and calcium-channel blocker in the prevention of cardiac events and mortality in patients with coronary artery disease. Post hoc analysis of the EUROPA study. Am Heart J 159:795–802

    Article  CAS  PubMed  Google Scholar 

  • Beta-blocker HATR Group (1982) A randomised trial of propranolol in patients with acute myocardial infarction. I: mortality results. JAMA 247:1707–1714

    Article  Google Scholar 

  • Beta-blocker HATR Group (1983) A randomized trial of propranolol in patients with acute myocardial infarction: II. morbidity results. JAMA 250:2814–2819

    Article  Google Scholar 

  • Boden WE, O’Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, Knudtson M, Dada M, Casperson P, Harris CL, Chaitman BR, Shaw L, Gosselin G, Nawaz S, Title LM, Gau G, Blaustein AS, Booth DC, Bates ER, Spertus JA, Berman DS, Mancini GBJ, Weintraub WS (2007) Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 356:1503–1516

    Article  CAS  PubMed  Google Scholar 

  • Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, Koprowicz K, McBride R, Teo K, Weintraub W (2011) Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med 365:2255–2267

    Article  PubMed  CAS  Google Scholar 

  • Borden WB, Redberg RF, Mushlin AI, Dai D, Kaltenbach LA, Spertus JA (2011) Patterns and Intensity of medical therapy in patients undergoing percutaneous coronary intervention. JAMA 305:1882–1889

    Article  CAS  PubMed  Google Scholar 

  • Brown ML, Inazu A, Hesler CB, Agellon LB, Mann C, Whitlock ME, Marcel YL, Milne RW, Koizumi J, Mabuchi H (1989) Molecular basis of lipid transfer protein deficiency in a family with increased high-density lipoproteins. Nature 342(6248):448–451

    Article  CAS  PubMed  Google Scholar 

  • Cannon CP (2011) High-density lipoprotein cholesterol as the holy grail. JAMA 306:2153–2155

    Article  CAS  PubMed  Google Scholar 

  • Cannon CP, Braunwald E, McCabe CH, Rader DJ, Rouleau JL, Belder R, Joyal SV, Hill KA, Pfeffer MA, Skene AM, Investigators PoAEaIT-TiMI (2004) Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 350:1495–1504

    Article  CAS  PubMed  Google Scholar 

  • CAPRICORN Investigators (2001) Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial. Lancet 357:1385–1390

    Article  Google Scholar 

  • Carter AA, Gomes T, Camacho X, Juurlink DN, Shah BR, Mamdani MM (2013) Risk of incident diabetes among patients treated with statins: population based study. BMJ 346:f2610

    Article  PubMed  PubMed Central  Google Scholar 

  • Cassese S, Byrne RA, Tada T, King LA, Kastrati A (2012) Clinical impact of extended dual antiplatelet therapy after percutaneous coronary interventions in the drug-eluting stent era: a meta-analysis of randomized trials. Eur Heart J 33:3078–3087

    Article  CAS  PubMed  Google Scholar 

  • Cholesterol Treatment Trialists’ (CTT), Collaboration BC, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N, Peto R, Barnes EH, Keech A, Simes J, Collins R (2010) Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 376:1670–1681

    Article  PubMed Central  CAS  Google Scholar 

  • Choudhry NK, Avorn J, Glynn RJ, Antman EM, Schneeweiss S, Toscano M, Reisman L, Fernandes J, Spettell C, Lee JL, Levin R, Brennan T, Shrank WH (2011) Full coverage for preventive medications after myocardial infarction. N Engl J Med 365:2088–2097

    Article  CAS  PubMed  Google Scholar 

  • Collaboration AT (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 373:1849–1860

    Article  CAS  Google Scholar 

  • Costa J, Borges M, David C, Vaz Carneiro A (2006) Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: meta-analysis of randomised controlled trials. BMJ 332:1115–1124

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Culver AL, Ockene IS, Balasubramanian R, Olendzki BC, Sepavich DM, Wactawski-Wende J, Manson JE, Qiao Y, Liu S, Merriam PA, Rahilly-Tierny C, Thomas JF, Berger JS, Ockene JK, Curb JD, Ma Y (2012) Statin use and risk of diabetes mellitus in postmenopausal women in the women’s health initiative. Arch Intern Med 172:144–152

    Article  PubMed  Google Scholar 

  • de Gaetano G, Collaborative Group of the Primary Prevention Project (2001) Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised trial in general practice. Collaborative group of the primary prevention project. Lancet 357:89–95

    Article  PubMed  Google Scholar 

  • Diao D, Wright JM, Cundiff DK, Gueyffier F (2012) Pharmacotherapy for mild hypertension. Cochrane Database Syst Rev 8:CD006742

    Google Scholar 

  • Dohi T, Miyauchi K, Okazaki S, Yokoyama T, Yanagisawa N, Tamura H, Kojima T, Yokoyama K, Kurata T, Daida H (2010) Early intensive statin treatment for six months improves long-term clinical outcomes in patients with acute coronary syndrome (Extended-ESTABLISH trial): a follow-up study. Atherosclerosis 210:497–502

    Article  CAS  PubMed  Google Scholar 

  • Eidelman RS, Hebert PR, Weisman SM, Hennekens CH (2003) An update on aspirin in the primary prevention of cardiovascular disease. Arch Intern Med 163(17):2006–2010

    Article  PubMed  Google Scholar 

  • Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the national cholesterol education program (NCEP) expert -panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment panel III). JAMA 285:2486–2497

    Article  Google Scholar 

  • Flack JM, Neaton J, Grimm R Jr, Shih J, Cutler J, Ensrud K, MacMahon S, Multiple Risk Factor Intervention Trial Research Group (1995) Blood pressure and mortality among men with prior myocardial infarction. Circulation 92:2437–2445

    Article  CAS  PubMed  Google Scholar 

  • Fox KM, EURopean Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease Investigators (2003) Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet 362:782–788

    Article  CAS  PubMed  Google Scholar 

  • Frey P, Waters DD, DeMicco DA, Breazna A, Samuels L, Pipe A, Wun C-C, Benowitz NL (2010) Impact of smoking on cardiovascular events in patients with coronary disease receiving contemporary medical therapy (from the treating to new targets [TNT] and the incremental decrease in end points through aggressive lipid lowering [IDEAL] trials). Am J Cardiol 107:145–150

    Article  PubMed  Google Scholar 

  • Frick MH, Elo O, Haapa K, Heinonen OP, Heinsalmi P, Helo P, Huttunen JK, Kaitaniemi P, Koskinen P, Manninen V (1987) Helsinki heart study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. N Engl J Med 317:1237–1245

    Article  CAS  PubMed  Google Scholar 

  • General Practice Research Framework (1998) Thrombosis prevention trial: randomised trial of low intensity anticoagulation with warfarin and low-dose aspirin in the primary prevention of ischaemic heart disease in men at increased risk. Lancet 351:233–241

    Article  Google Scholar 

  • Gerber Y, Rosen LJ, Goldbourt U, Benyamini Y, Drory Y (2009) Smoking status and long-term survival after first acute myocardial infarction: a population-based cohort study. J Am Coll Cardiol 54:2382–2387

    Article  PubMed  Google Scholar 

  • Go AS, Bauman MA, King MBS et al (2013) An effective approach to high blood pressure control: a science advisory from the American heart association, the American college of cardiology, and the centers for disease control and prevention [published online ahead of print 15 Nov 2013]. Hypertension. doi:10.1161/HYP.0000000000000003. http://hyper.ahajournals.org/content/early/2013/11/14/HYP.0000000000000003.citation. Accessed 19 Nov 2013

  • Goff DC Jr, Lloyd-Jones DM, Bennett G et al (2013) ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American college of cardiology/American heart association task force on practice guidelines [published online ahead of print 12 Nov 2013]. Circulation. doi:10.1161/01.cir.0000437741.48606.98. http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437741.48606.98.full.pdf+html?sid=%2053af8168-4e81-45f3-81dc-7771aff9d486. Accessed 13 Nov 2013

  • Golomb BA, Evans MA, Dimsdale JE, White HL (2012) Effects of statins on energy and fatigue with exertion: results from a randomized controlled trial. Arch Intern Med 172:1180–1182

    PubMed  PubMed Central  Google Scholar 

  • Gotto AM (2000) Insights on treating an over-the-counter-type subgroup: data from the air force/texas coronary atherosclerosis prevention study population. Am J Cardiol 85:8–14

    Article  Google Scholar 

  • Grundy SM (2002) Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Circulation 106(25):3143–3421

    Google Scholar 

  • Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C, For the Conference Participants (2004a) Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 109:433–438

    Article  PubMed  Google Scholar 

  • Grundy SM, Cleeman JI, Bairey Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, Pasternak RC, Smith SC Jr, Stone NJ, Coordinating Committee of the National Cholesterol Education P (2004b) Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. J Am Coll Cardiol 44:720–732

    Article  PubMed  Google Scholar 

  • Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F (2005) Diagnosis and management of the metabolic syndrome. Circulation 112:2735–2752

    Article  PubMed  Google Scholar 

  • Guerin M, Le Goff W, Duchene E, Julia Z, Nguyen T, Thuren T, Shear CL, Chapman MJ (2008) Inhibition of CETP by torcetrapib attenuates the atherogenicity of postprandial TG-rich lipoproteins in type IIB hyperlipidemia. Arterioscler Thromb Vasc Biol 28:148–154

    Article  CAS  PubMed  Google Scholar 

  • Gutierrez J, Ramirez G, Rundek T, Sacco RL (2012) Statin therapy in the prevention of recurrent cardiovascular events: a sex-based meta-analysis. Arch Intern Med 172:909–919

    Article  CAS  PubMed  Google Scholar 

  • Hajek P, Stead LF, West R, Jarvis M, Lancaster T (2009) Relapse prevention interventions for smoking cessation. Cochrane Database Syst Rev 1

    Google Scholar 

  • Hansson L, Zanchetti A, Carruthers SG, Dahlöf B, Elmfeldt D, Julius S, MĂ©nard J, Rahn K, Wedel H, Westerling S (1998) Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. HOT study group. Lancet 351:1755–1762

    Article  CAS  PubMed  Google Scholar 

  • Hansson L, Hedner T, Lund-Johansen P, Kjeldsen SE, Lindholm LH, Syvertsen JO, Lanke J, de Faire U, Dahlöf B, Karlberg BE (2000) Randomised trial of effects of calcium antagonists compared with diuretics and ĂŽ2-blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet 356:359–365

    Article  CAS  PubMed  Google Scholar 

  • Hjalmarson Ă…, Herlitz J, Málek I, RydĂ©n L, Vedin A, Waldenström A, Wedel H, Elmfeldt D, Holmberg S, Nyberg G, Swedberg K, Waagstein F, Waldenström J, Wilhelmsen L, Wilhelmsson C (1981) Effect on mortality of metoprolol in acute myocardial infarction: a double-blind randomised trial. Lancet 318:823–827

    Article  Google Scholar 

  • Jamerson K, Weber MA, Bakris GL, Dahlöf B, Pitt B, Sh V, Hester A, Gupte J, Gatlin M, Velazquez EJ, ACCOMPLISH Trial Investigators (2008) Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 359:2417–2428

    Article  CAS  PubMed  Google Scholar 

  • James PA, Oparil S, Carter BL et al (2014) Evidence-based guideline for the management of high blood pressure in adults. Report from the panel members appointed to the eighth joint national committee (JNC 8) [published online ahead of print 18 Dec 2013]. JAMA. doi:10.1001/jama.2013.284427. http://jama.jamanetwork.com/article.aspx?articleid=1791497. Accessed 18 Dec 2013

  • Kannel WB (1986) Silent myocardial ischemia and infarction: insights from the framingham study. Cardiol Clin 4:583–591

    CAS  PubMed  Google Scholar 

  • Keating GM (2011) Fenofibrate: a review of its lipid-modifying effects in dyslipidemia and its vascular effects in type 2 diabetes mellitus. Am J Cardiovasc Drugs 11:227–247

    Article  CAS  PubMed  Google Scholar 

  • Ko DT, Wijeysundera HC, Jackevicius CA, Yousef A, Wang J, Tu JV (2013) Diabetes mellitus and cardiovascular events in older patients with myocardial infarction prescribed intensive-dose and moderate-dose statins. Circ Cardiovasc Qual Outcomes 6:315–322

    Article  PubMed  Google Scholar 

  • Komocsi A, Vorobcsuk A, Kehl D, Aradi D (2012) Use of new-generation oral anticoagulant agents in patients receiving antiplatelet therapy after an acute coronary syndrome: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med 172:1537–1545

    Article  PubMed  Google Scholar 

  • Larosa JC, Grundy SM, Waters D et al (2005) Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 352:1425–1435

    Article  CAS  PubMed  Google Scholar 

  • Law MR, Morris JK, Wald NJ (2009) Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 338:b1665

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Levine DA, Funkhouser EM, Houston TK, Gerald JK, Johnson-Roe N, Allison JJ, Richman J, Kiefe CI (2011) Improving care after myocardial infarction using a 2-year internet-delivered intervention: the department of veterans affairs myocardial infarction-plus cluster-randomized trial. Arch Intern Med 171:1910–1917

    Article  PubMed  Google Scholar 

  • Lièvre M, Cucherat M (2010) Aspirin in the secondary prevention of cardiovascular disease: an update of the APTC meta-analysis. Fundam Clin Pharmacol 24:385–391

    Article  PubMed  CAS  Google Scholar 

  • Lindholm LH, Carlberg B, Samuelsson O (2005) Should beta blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 366:1545–1553

    Article  CAS  PubMed  Google Scholar 

  • MacMahon S, Rodgers A, Neal B, Chalmers J (1997) Blood pressure lowering for the secondary prevention of myocardial infarction and stroke. Hypertension 29:537–538

    Article  CAS  PubMed  Google Scholar 

  • Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Struijker Boudier HAJ, Zanchetti A (2007) 2007 guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 28:1462–1536

    PubMed  Google Scholar 

  • McMurray J, Solomon S, Pieper K, Reed S, Rouleau J, Velazquez E, White H, Howlett J, Swedberg K, Maggioni A, Køber L, Van de Werf F, Califf R, Pfeffer M (2006) The effect of valsartan, captopril, or both on atherosclerotic events after acute myocardial infarction: an analysis of the valsartan in acute myocardial infarction trial (VALIANT). J Am Coll Cardiol 47:726–733

    Article  CAS  PubMed  Google Scholar 

  • Messerli FH, Grossman E, Goldbourt U (1998) Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? A systematic review. JAMA 279:1903–1907

    Article  CAS  PubMed  Google Scholar 

  • Mills EJ, Wu P, Chong G, Singh S, Akl EA, Eyawo O, Guyatt G, Berwanger O, Briel M (2011) Efficacy and safety of statin treatment for cardiovascular disease: a network meta-analysis of 170,255 patients from 76 randomized trials. QJM 104:109–124

    Article  CAS  PubMed  Google Scholar 

  • Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, Dolor RJ, Ganiats TG, Gomes AS, Gornik HL, Gracia C, Gulati M, Haan CK, Judelson DR, Keenan N, Kelepouris E, Michos ED, Newby LK, Oparil S, Ouyang P, Oz MC, Petitti D, Pinn VW, Redberg RF, Scott R, Sherif K, Smith SCJ, Sopko G, Steinhorn RH, Stone NJ, Taubert KA, Todd BA, Urbina E, Wenger NK, ftEPWG (2007) Evidence-based guidelines for cardiovascular disease prevention in women. Circulation 115:1481–1501

    Article  PubMed  Google Scholar 

  • No Listed Authors (1977) Reduction in mortality after myocardial infarction with long-term beta-adrenoceptor blockade. Multicentre international study: supplementary report. BMJ 2:419–421

    Article  Google Scholar 

  • Norwegian, Group MS (1981) Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med 304:801–807

    Article  Google Scholar 

  • ONTARGET Investigators, Yusuf S, Teo K, Pogue J, Dyal L, Copland I, Schumacher H, Dagenais G, Sleight P, Anderson C (2008) Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med 358:1547–1559

    Article  Google Scholar 

  • Oparil S, Davis BR, Cushman WC, et al. (2013) Morality and morbidity during and after antihypertensive and lipid-lowering treatment to prevent heart attack trial. Results by sex. Hypertension 61:977–986

    CAS  PubMed  Google Scholar 

  • Pedersen TR, Faergeman O, Kastelein JJ, Olsson AG, Tikkanen MJ, Holme I, Larsen ML, Bendiksen FS, Lindahl C, Szarek M, Tsai J (2005) High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial. JAMA 294:2437–2445

    Article  CAS  PubMed  Google Scholar 

  • Peto R, Gray R, Collins R, Wheatley K, Hennekens C, Jamrozik K, Warlow C, Hafner B, Thompson E, Norton S, Gilliland J, Doll R (1988) Randomised trial of prophylactic daily aspirin in British male doctors. Br Med J 296:313–316

    Article  CAS  Google Scholar 

  • Petretta M, Costanzo P, Perrone-Filardi P, Chiariello M (2010) Impact of gender in primary prevention of coronary heart disease with statin therapy: a meta-analysis. Int J Cardiol 138:25–31

    Article  PubMed  Google Scholar 

  • Physicians’ Health Study (1989) Final report on the aspirin component of the ongoing physicians’ health study. N Engl J Med 321:129–135

    Article  Google Scholar 

  • Pitt B, Remme W, Zannad F (2003) Eplerenone a selective aldosterone blocker in patients with left ventricular dysfunction after myocardial infarction. New Eng J Med 348:1309–1321

    Article  CAS  PubMed  Google Scholar 

  • Preiss D, Seshasai S, Welsh P et al (2011) Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA 305:2556–2564

    Article  CAS  PubMed  Google Scholar 

  • Rapaport E, Gheorghiade M (1996) Pharmacologic therapies after myocardial infarction. Am J Med 101:4A61S–4A69S

    Article  CAS  PubMed  Google Scholar 

  • Ridker PM, Cook N, Lee I-M, Gordon D, Gaziano JM, Manson JE, Hennekens CH, Buring JE (2005) A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 352:1293–1304

    Article  CAS  PubMed  Google Scholar 

  • Ridker PM, Fonseca FAH, Jacques Genest J, Gotto AM, Kastelein JJP, Khurmi NS, Koenig W, Libby P, Lorenzatti AJ, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ, JUPITER Trial Study Group (2007) Baseline characteristics of participants in the JUPITER trial, a randomized placebo-controlled primary prevention trial of statin therapy among individuals with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein. Am J Cardiol 100:1659–1664

    Article  PubMed  Google Scholar 

  • Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AMJ, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ, For the JUPITER Study Group (2008) Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 359:2195–2207

    Article  CAS  PubMed  Google Scholar 

  • Robins SJ, Collins D, Wittes JT et al (2001) Relation of gemfibrozil treatment and lipid levels with major coronary events: Va-hit: a randomized controlled trial. JAMA 285:1585–1591

    Article  CAS  PubMed  Google Scholar 

  • Romero SC, Rosa KMD, Linz PE (2008) Aspirin for primary prevention of coronary heart disease: using the framingham risk score to improve utilization in a primary care clinic. South Med J 101:725–729

    Article  PubMed  Google Scholar 

  • Ross SD, Allen IE, Connelly JE, Korenblat BM, Smith ME, Bishop D, Luo D (1999) Clinical outcomes in statin treatment trials: a meta-analysis. Arch Intern Med 159:1793–1802

    Article  CAS  PubMed  Google Scholar 

  • Royal College of Physicians (UK) (2006) National collaborating centre for chronic conditions (UK) hypertension: management in adults in primary care: pharmacological update, vol 34. Royal College of Physicians (UK), London

    Google Scholar 

  • Sattar N, Preiss D, Murray HM et al (2010) Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet 375:735–742

    Article  CAS  PubMed  Google Scholar 

  • Schwartz GG, Olsson AG, Ezekowitz MD et al (2001) Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the miracl study: a randomized controlled trial. JAMA 285:1711–1718

    Article  CAS  PubMed  Google Scholar 

  • Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, Macfarlane PW, McKillop JH, Packard CJ, For the West of Scotland Coronary Prevention Study Group (1995) Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 333:1301–1308

    Article  CAS  PubMed  Google Scholar 

  • Simpson SH, Gamble JM, Mereu L, Chambers T (2011) Effect of aspirin dose on mortality and cardiovascular events in people with diabetes: a meta-analysis. J Gen Intern Med 26:1336–1344

    Article  PubMed  PubMed Central  Google Scholar 

  • Smit ES, de Vries H, Hoving C (2012) Effectiveness of a web-based multiple tailored smoking cessation program: a randomized controlled trial among Dutch adult smokers. J Med Internet Res 14:e82

    Article  PubMed  PubMed Central  Google Scholar 

  • Smith SC Jr, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, Gibbons RJ, Grundy SM, Hiratzka LF, Jones DW, Lloyd-Jones DM, Minissian M, Mosca L, Peterson ED, Sacco RL, Spertus J, Stein JH, Taubert KA (2011) AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. J Am Coll Cardiol 58:2432–2446

    Article  PubMed  Google Scholar 

  • Sniderman A, Thanassoulis G, Couture P, Williams K, Alam A, Furberg CD (2012) Is lower and lower better and better? A re-evaluation of the evidence from the cholesterol treatment trialists’ collaboration meta-analysis for low-density lipoprotein lowering. J Clin Lipidol 6:303–309

    Article  PubMed  Google Scholar 

  • Spector R, Snapinn SM (2011) Statins for secondary prevention of cardiovascular disease: the right dose. Pharmacology 87:63–69

    Article  CAS  PubMed  Google Scholar 

  • Stone NJ, Robinson J, Lichtenstein AH et al (2013) 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. Print ISSN: 0009–7322. Online ISSN: 1524–4539. http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a.full.pdf+html

  • Swan GE, McClure JB, Jack LM, Zbikowski SM, Javitz HS, Catz SL, Deprey M, Richards J, McAfee TA (2010) Behavioral counseling and varenicline treatment for smoking cessation. Am J Prev Med 38:482–490

    Article  PubMed  PubMed Central  Google Scholar 

  • Taylor F, Huffman MD, Macedo AF, Moore TH, Burke M, Davey Smith G, Ward K, Ebrahim S (2013) Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev 1, CD004816. doi:0.1002/14651858.CD004816.pub5.

    Google Scholar 

  • The Heart Outcomes Prevention Evaluation Study Investigators (2000) Effects of an angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 342:145–153

    Article  Google Scholar 

  • Trials Gov C (2012) A study of evacetrapib in high-risk vascular disease (ACCELERATE). http://clinicaltrials.gov/show/NCT01687998

  • US Food and Drug Administration (2012) FDA announces safety changes in labeling for some cholesterol-lowering drugs. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm293623.htm

  • Vakkilainen J, Steiner G, Ansqur JC, Aubin F, Rattier S, Foucher C, Hamsten A, Taskinen MR, DAIS Group (2003) Relationships between low-density lipoprotein particle size, plasma lipoproteins, and progression of coronary artery disease: the diabetes atherosclerosis intervention study (DAIS). Circulation 107:1733–1737

    Article  PubMed  Google Scholar 

  • Vale N, Nordmann AJ, Schwartz GG, de Lemos J, Colivicchi F, den Hartog F, Ostadal P, Macin SM, Liem AH, Mills E, Bhatnagar N, Bucher HC, Briel M (2011) Statins for acute coronary syndrome. Cochrane Database Syst Rev 6:CD006870

    Google Scholar 

  • Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, Horrow J, Husted S, James S, Katus H, Mahaffey KW, Scirica BM, Skene A, Steg PG, Storey RF, Harrington RA, PLATO Investigators, Freij A, ThorsĂ©n M (2009) Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 361:1045–1057

    Article  CAS  PubMed  Google Scholar 

  • Waters DD, Ku I (2009) Early statin therapy in acute coronary syndromes: the successful cycle of evidence, guidelines, and implementation. J Am Coll Cardiol 54:1434–1437

    Article  CAS  PubMed  Google Scholar 

  • Weber MA, Jamerson K, Bakris GL, Weir MR, Zappe D, Zhang Y, Dahlof B, Velazquez EJ, Pitt B (2013) Effects of body size and hypertension treatments on cardiovascular event rates: subanalysis of the ACCOMPLISH randomised controlled trial. Lancet 381(9866):537–545

    Article  PubMed  Google Scholar 

  • Weintraub WS, Mandel L, Weiss SA (2013) Antiplatelet therapy in patients undergoing percutaneous coronary intervention: economic considerations. Pharmacoeconomics 31(11):959–970

    Article  PubMed  PubMed Central  Google Scholar 

  • Wolff T, Miller T, Ko S (2009) Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 150:405–410

    Article  PubMed  Google Scholar 

  • Yusuf S, Lessem J, Jha P, Lonn E (1993) Primary and secondary prevention of myocardial infarction and strokes: an update of randomly allocated, controlled trials. J Hypertens Suppl 11:S61–S73

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, University of California, 4860 Y Street, Suite 2820, Sacramento, CA, 95817, USA

    C. Tissa Kappagoda & Ezra A. Amsterdam

  2. Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA

    Nanette K. Wenger

  3. Emory Heart and Vascular Center, Emory University School of Medicine, Atlanta, GA, USA

    Nanette K. Wenger

Authors
  1. C. Tissa Kappagoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ezra A. Amsterdam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nanette K. Wenger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ezra A. Amsterdam .

Editor information

Editors and Affiliations

  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Kappagoda, C.T., Amsterdam, E.A., Wenger, N.K. (2015). Drugs in the Primary and Secondary Prevention of Coronary Artery Disease. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_55

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-37078-6_55

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-37077-9

  • Online ISBN: 978-3-642-37078-6

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation