doi: 10.1161/hc3801.097475
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(Circulation. 2001;104:1577.)
© 2001 American Heart Association, Inc.
AHA/ACC Scientific Statement |
AHA/ACC Guidelines for Preventing Heart Attack and Death in Patients With Atherosclerotic Cardiovascular Disease: 2001 Update
A Statement for Healthcare Professionals From the American Heart Association and the American College of Cardiology
The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest., This statement was approved by the American Heart Association Science Advisory and Coordinating Committee in June 2001 and by the American College of Cardiology Board of Trustees in July 2001. A single reprint is available by calling 800-242-8721 (US only) or writing the American Heart Association, Public Information, 7272 Greenville Ave, Dallas, TX 75231-4596. Ask for reprint No. 71-0214. To purchase additional reprints: up to 999 copies, call 800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies, call 214-706-1466, fax 214-691-6342, or e-mail pubauth@heart.org. To make photocopies for personal or educational use, call the Copyright Clearance Center, 978-750-8400.
Key Words: AHA Scientific Statements • prevention • risk factors • atherosclerosis
Since the original publication (in 1995) of the American Heart Association (AHA) consensus statement on secondary prevention, which was endorsed by the American College of Cardiology (ACC), important evidence from clinical trials has emerged that further supports the merits of aggressive risk reduction therapies for patients with atherosclerotic cardiovascular disease. As noted in that statement, aggressive risk factor management clearly improves patient survival, reduces recurrent events and the need for interventional procedures, and improves the quality of life for these patients.
The compelling evidence from recent clinical trials was the impetus to revise the 1995 guidelines (Table). As examples, the many lipid reduction trials have generated significant changes in the National Heart, Lung, and Blood Institute’s Adult Treatment Panel III report. This report further defined target cholesterol levels, expanded indications for drug treatment, and initiated therapy earlier. Accumulating ß-blocker data have resulted in broader indications for a larger patient group. The Heart Outcomes Prevention Evaluation (HOPE) trial has demonstrated the benefit of ACE inhibitor therapy in high-risk patients with cardiovascular disease without a history of an acute event. Further data from ongoing trials should provide insight into the potential benefits of treating lower risk patients with combined therapies. The Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE) trial has provided evidence for clopidogrel benefit in certain patients. Diabetes management recommendations have been updated to include recent guidelines from the American Diabetes Association for risk factor management of diabetics and the growing body of evidence showing diabetics at high risk for cardiovascular events. The Heart and Estrogen/progestin Replacement Study (HERS) documented that hormone replacement therapy is ineffective for secondary prevention. The writing group revising this document also considered other important trials and reports, and they are included in the selected reading list.
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In the 6 years since the guidelines were first published, 2 other developments have made them even more important in clinical care: the aging of the population continues to expand the number of patients living with a diagnosis of cardiovascular disease (now estimated at 12.4 million), and the multiple studies of the actual use of these recommended therapies in appropriate patients, while showing slow improvement, have continued to support the discouraging conclusion that a large proportion of patients in whom therapies are indicated are not receiving those therapies in actual clinical practice. The AHA and ACC continue to urge that all medical care settings in which these patients are managed organize a specific plan to identify appropriate patients, provide practitioners with useful reminder clues based on the guidelines, and continuously assess the success achieved in providing all appropriate therapies to all of the patients who can benefit from them.
Selected Reading
1.
Adult Treatment Panel III. 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. JAMA. 2001; 285: 2486–2497.
2. American Diabetes Association clinical practice recommendations 2001. Diabetes Care. 2001;24(suppl 1):s33–s43.
3. Antiplatelet Trialists’ Collaboration. Secondary prevention of vascular disease by prolonged antiplatelet treatment. Br Med J (Clin Res Ed). 1988; 296: 320–331.
4.
Antiplatelet Trialists’ Collaboration. Collaborative overview of randomised trials of antiplatelet therapy, I: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ. 1994; 308: 81–106.
5.
Braunwald E, Antman EM, Beasley JW, et al. ACC/AHA guidelines for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). Circulation. 2000; 102: 1193–1209.
6. CAPRIE Steering Committee. A randomized, blinded trial of clopidogrel versus aspirin in patients at risk of ischemic events (CAPRIE). Lancet. 1996; 348: 1329–1339.[Medline] [Order article via Infotrieve]
7.
Cairns JA, Markham BA. Economics and efficacy in choosing oral anticoagulants or aspirin after myocardial infarction. JAMA. 1995; 273: 965–967.
8.
DeBusk RF, Miller NH, Superko HR, et al. A case-management system for coronary risk factor modification after acute myocardial infarction. Ann Intern Med. 1994; 120: 721–729.
9. Fletcher GF, Balady GJ, Amsterdam E, et al. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. In press.
10. Fonarow GC, Gawlinski A, Moughrabi S, et al. Improved treatment of coronary heart disease by implementation of a cardiac hospitalization atherosclerosis management program (CHAMP). Am J Cardiol. 2001; 87: 819–822.[Medline] [Order article via Infotrieve]
11. Gibbons RJ, Chatterjee K, Daley J, et al, and the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). Guidelines for the management of patients with chronic stable angina. Circulation. 1999; 99: 2828–2848.
12.
Grundy SM, Benjamin IJ, Burke GL, et al. Diabetes mellitus: a major risk factor for cardiovascular disease: a joint editorial by the American Diabetes Association, the National Heart, Lung, and Blood Institute, the Juvenile Diabetes Foundation International, the National Institute of Diabetes and Digestive and Kidney Diseases, and the American Heart Association. Circulation. 1999; 100: 1132–1133.
13. Hambrecht R, Niebauer J, Marburger C, et al. Various intensities of leisure time physical activity in patients with coronary artery disease: effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions. J Am Coll Cardiol. 1993; 22: 468–477.[Abstract]
14.
Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients: the Heart Outcomes Prevention Evaluation (HOPE) Study Investigators. N Engl J Med. 2000; 342: 145–153.
15.
Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women: Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA. 1998; 280: 605–613.
16. Krumholz HM, Cohen BJ, Tsevat J, et al. Cost-effectiveness of a smoking cessation program after myocardial infarction. J Am Coll Cardiol. 1993; 22: 1697–1702.[Abstract]
17.
Mosca L, Collins P, Herrington DM, et al. Hormone replacement therapy and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 2001; 104: 499–503.
18. Timolol-induced reduction in mortality and reinfarction in patents surviving acute myocardial infarction. N Engl J Med. 1981;304:801–807.
19.
O’Keefe JH, Wetzel M, Moe RR, et al. Should an angiotensin-converting enzyme inhibitor be standard therapy for patients with atherosclerotic disease? J Am Coll Cardiol. 2001; 37: 1–8.
20.
Pearson T, Rapaport E, Criqui M, et al. Optimal risk factor management in the patient after coronary revascularization: a statement for healthcare professionals from an American Heart Association writing group. Circulation. 1994; 90: 3125–3133.
21. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383–1389.
22.
Pepine CJ. Aspirin and newer orally active antiplatelet agents in the treatment of the post-myocardial infarction patient. J Am Coll Cardiol. 1998; 32: 1126–1128.
23.
Pfeffer MA. ACE inhibition in acute myocardial infarction. N Engl J Med. 1995; 332: 118–120.
24. Pfeffer MA, Braunwald E, Moyé LA, et al, on behalf of the SAVE Investigators. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction: results of the survival and ventricular enlargement trial. N Engl J Med. 1992; 327: 669–677.[Abstract]
25. Pfeffer MA, Domanski M, Verter J, et al, for the PEACE Investigators. The continuation of the Prevention of Events with Angiotensin-Converting Enzyme inhibition (PEACE) trial. Am Heart J. 2001; 142: 375–377.[Medline] [Order article via Infotrieve]
26. Quinn TG, Alderman EL, McMillan A, et al. Development of new coronary atherosclerotic lesions during a 4-year multifactor risk reduction program: the Stanford Coronary Risk Intervention Project (SCRIP). J Am Coll Cardiol. 1994; 24: 900–908.[Abstract]
27. Ryan TJ, Anderson L, Antman EM, et al. ACC/AHA guidelines for the management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol. 1996; 28: 1328–1428.[Medline] [Order article via Infotrieve]
28.
Sharis PJ, Cannon CP, Loscalzo J. The antiplatelet effects of ticlopidine and clopidogrel. Ann Intern Med. 1998; 129: 394–405.
29. The Sixth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Arch Intern Med. 1997;157:2413–2446.
30. Smith SC Jr, Blair SN, Criqui MH, et al. Preventing heart attack and death in patients with coronary disease. Circulation. 1995; 92: 2–4.
31.
Smith P, Arnesen H, Abdelnoor M. Effects of long-term anticoagulant therapy in subgroups after acute myocardial infarction. Arch Intern Med. 1992; 152: 993–997.
32. Smith P, Arnesen H, Holme I. The effect of warfarin on mortality and reinfarction after myocardial infarction. N Engl J Med. 1990; 323: 147–152.[Abstract]
33.
Viscoli CM, Horwitz RI, Singer BH. Beta-blockers after myocardial infarction: influence of first-year clinical course on long-term effectiveness. Ann Intern Med. 1993; 118: 99–105.
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Developed in Collaboration With the American Colle, Endorsed by the Heart Rhythm Society, S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure) J. Am. Coll. Cardiol., September 20, 2005; 46(6): 1116 - 1143. [Full Text] [PDF]
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S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, K. Michl, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): Developed in Collaboration With the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: Endorsed by the Heart Rhythm Society Circulation, September 20, 2005; 112(12): 1825 - 1852. [Full Text] [PDF]
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 F. Lopez-Jimenez, S. Bhatia, M. L. Collazo-Clavell, M. G. Sarr, and V. K. Somers Safety and Efficacy of Bariatric Surgery in Patients With Coronary Artery Disease Mayo Clin. Proc., September 1, 2005; 80(9): 1157 - 1162. [Abstract] [PDF]
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J. J. Saseen ASHP Therapeutic Position Statement on the Daily Use of Aspirin for Preventing Cardiovascular Events Am. J. Health Syst. Pharm., July 1, 2005; 62(13): 1398 - 1405. [Full Text] [PDF]
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T. J. Bunch, S. C. Hammill, and R. D. White Outcomes After Ventricular Fibrillation Out-of-Hospital Cardiac Arrest: Expanding the Chain of Survival Mayo Clin. Proc., June 1, 2005; 80(6): 774 - 782. [Abstract] [PDF]
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 S. I. Rennard Clinical Approach to Patients with Chronic Obstructive Pulmonary Disease and Cardiovascular Disease Proceedings of the ATS, April 1, 2005; 2(1): 94 - 100. [Abstract] [Full Text] [PDF]
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L. Mosca, A. H. Linfante, E. J. Benjamin, K. Berra, S. N. Hayes, B. W. Walsh, R. P. Fabunmi, J. Kwan, T. Mills, and S. L. Simpson National Study of Physician Awareness and Adherence to Cardiovascular Disease Prevention Guidelines Circulation, February 1, 2005; 111(4): 499 - 510. [Abstract] [Full Text] [PDF]
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A. S. Leon, B. A. Franklin, F. Costa, G. J. Balady, K. A. Berra, K. J. Stewart, P. D. Thompson, M. A. Williams, and M. S. Lauer Cardiac Rehabilitation and Secondary Prevention of Coronary Heart Disease: An American Heart Association Scientific Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in Collaboration With the American Association of Cardiovascular and Pulmonary Rehabilitation Circulation, January 25, 2005; 111(3): 369 - 376. [Abstract] [Full Text] [PDF]
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T. J. Gluckman, M. Sachdev, S. P. Schulman, and R. S. Blumenthal A Simplified Approach to the Management of Non-ST-Segment Elevation Acute Coronary Syndromes JAMA, January 19, 2005; 293(3): 349 - 357. [Abstract] [Full Text] [PDF]
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 M. E. Tinetti, S. T. Bogardus Jr., and J. V. Agostini Potential Pitfalls of Disease-Specific Guidelines for Patients with Multiple Conditions N. Engl. J. Med., December 30, 2004; 351(27): 2870 - 2874. [Full Text] [PDF]
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 M. Betancourt, R. B. Van Stavern, D. Share, P. Gardella, M. Martus, and S. Chaturvedi Are patients receiving maximal medical therapy following carotid endarterectomy? Neurology, December 14, 2004; 63(11): 2011 - 2015. [Abstract] [Full Text] [PDF]
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S. M. Grundy Atherosclerosis Imaging and the Future of Lipid Management Circulation, December 7, 2004; 110(23): 3509 - 3511. [Full Text] [PDF]
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The PEACE Trial Investigators Angiotensin-Converting-Enzyme Inhibition in Stable Coronary Artery Disease N. Engl. J. Med., November 11, 2004; 351(20): 2058 - 2068. [Abstract] [Full Text] [PDF]
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Writing Committee Members, E. M. Antman, D. T. Anbe, P. W. Armstrong, E. R. Bates, L. A. Green, M. Hand, J. S. Hochman, H. M. Krumholz, F. G. Kushner, et al. ACC/AHA guidelines for the management of patients with ST-Elevation myocardial infarction--executive summary: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (writing committee to revise the 1999 guidelines for the management of patients with acute myocardial infarction) J. Am. Coll. Cardiol., August 4, 2004; 44(3): 671 - 719. [Full Text] [PDF]
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E. M. Antman, D. T. Anbe, P. W. Armstrong, E. R. Bates, L. A. Green, M. Hand, J. S. Hochman, H. M. Krumholz, F. G. Kushner, G. A. Lamas, et al. ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction) Circulation, August 3, 2004; 110(5): 588 - 636. [Full Text] [PDF]
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 Task Force Members, J. Lopez-Sendo, K. Swedberg, J. McMurray, J. Tamargo, A. P. Maggioni, H. Dargie, M. Tendera, F. Waagstein, J. Kjekshus, et al. Expert consensus document on {beta}-adrenergic receptor blockers: The Task Force on Beta-Blockers of the European Society of Cardiology Eur. Heart J., August 1, 2004; 25(15): 1341 - 1362. [Full Text] [PDF]
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T. J. Gluckman, B. Baranowski, M. D. Ashen, C. A. Henrikson, M. McAllister, J. B. Braunstein, and R. S. Blumenthal A Practical and Evidence-Based Approach to Cardiovascular Disease Risk Reduction Arch Intern Med, July 26, 2004; 164(14): 1490 - 1500. [Abstract] [Full Text] [PDF]
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E. R. Cox, M. Frisse, A. Behm, and K. A. Fairman Over-the-Counter Pain Reliever and Aspirin Use Within a Sample of Long-term Cyclooxygenase 2 Users Arch Intern Med, June 14, 2004; 164(11): 1243 - 1246. [Full Text] [PDF]
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R. D. Brook, B. Franklin, W. Cascio, Y. Hong, G. Howard, M. Lipsett, R. Luepker, M. Mittleman, J. Samet, S. C. Smith Jr, et al. Air Pollution and Cardiovascular Disease: A Statement for Healthcare Professionals From the Expert Panel on Population and Prevention Science of the American Heart Association Circulation, June 1, 2004; 109(21): 2655 - 2671. [Abstract] [Full Text] [PDF]
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D. Colquhoun, A. Keech, D. Hunt, I. Marschner, J. Simes, P. Glasziou, H. White, P. Barter, A. Tonkin, and for the LIPID Study Investigators Effects of pravastatin on coronary events in 2073 patients with low levels of both low-density lipoprotein cholesterol and high-density lipoprotein cholesterol: results from the LIPID study Eur. Heart J., May 1, 2004; 25(9): 771 - 777. [Abstract] [Full Text] [PDF]
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N. F. Gordon, M. Gulanick, F. Costa, G. Fletcher, B. A. Franklin, E. J. Roth, and T. Shephard Physical Activity and Exercise Recommendations for Stroke Survivors: An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical Activity, and Metabolism; and the Stroke Council Stroke, May 1, 2004; 35(5): 1230 - 1240. [Full Text] [PDF]
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N. F. Gordon, M. Gulanick, F. Costa, G. Fletcher, B. A. Franklin, E. J. Roth, and T. Shephard Physical Activity and Exercise Recommendations for Stroke Survivors: An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical Activity, and Metabolism; and the Stroke Council Circulation, April 27, 2004; 109(16): 2031 - 2041. [Full Text] [PDF]
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Expert Panel/Writing Group, L. Mosca, L. J. Appel, E. J. Benjamin, K. Berra, N. Chandra-Strobos, R. P. Fabunmi, D. Grady, C. K. Haan, S. N. Hayes, et al. Evidence-based guidelines for cardiovascular disease prevention in women J. Am. Coll. Cardiol., March 3, 2004; 43(5): 900 - 921. [Abstract] [Full Text] [PDF]
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 L. Mosca and for the Expert Panel/WritingGroup Summary of the American Heart Association's Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women Arterioscler Thromb Vasc Biol, March 1, 2004; 24(3): 394 - 396. [Full Text]
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L. Mosca, L. J. Appel, E. J. Benjamin, K. Berra, N. Chandra-Strobos, R. P. Fabunmi, D. Grady, C. K. Haan, S. N. Hayes, D. R. Judelson, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women Arterioscler Thromb Vasc Biol, March 1, 2004; 24(3): e29 - 50. [Full Text]
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D. Mukherjee, J. Fang, S. Chetcuti, M. Moscucci, E. Kline-Rogers, and K. A. Eagle Impact of Combination Evidence-Based Medical Therapy on Mortality in Patients With Acute Coronary Syndromes Circulation, February 17, 2004; 109(6): 745 - 749. [Abstract] [Full Text] [PDF]
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L. Mosca, L. J. Appel, E. J. Benjamin, K. Berra, N. Chandra-Strobos, R. P. Fabunmi, D. Grady, C. K. Haan, S. N. Hayes, D. R. Judelson, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women Circulation, February 10, 2004; 109(5): 672 - 693. [Full Text] [PDF]
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C. H. Hennekens, F. M. Sacks, A. Tonkin, J. W. Jukema, R. P. Byington, B. Pitt, D. A. Berry, S. M. Berry, N. F. Ford, A. J. Walker, et al. Additive Benefits of Pravastatin and Aspirin to Decrease Risks of Cardiovascular Disease: Randomized and Observational Comparisons of Secondary Prevention Trials and Their Meta-analyses Arch Intern Med, January 12, 2004; 164(1): 40 - 44. [Abstract] [Full Text] [PDF]
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H. D. Aronow, G. M. Novaro, M. S. Lauer, D. M. Brennan, A. M. Lincoff, E. J. Topol, D. J. Kereiakes, and S. E. Nissen In-Hospital Initiation of Lipid-Lowering Therapy After Coronary Intervention as a Predictor of Long-term Utilization: A Propensity Analysis Arch Intern Med, November 24, 2003; 163(21): 2576 - 2582. [Abstract] [Full Text] [PDF]
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M. M. McDermott, A. L. Mandapat, A. Moates, M. Albay, E. Chiou, L. Celic, and P. Greenland Knowledge and Attitudes Regarding Cardiovascular Disease Risk and Prevention in Patients With Coronary or Peripheral Arterial Disease Arch Intern Med, October 13, 2003; 163(18): 2157 - 2162. [Abstract] [Full Text] [PDF]
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M. E van der Elst, H. Buurma, M. L Bouvy, and A. de Boer Drug Therapy for Prevention of Recurrent Myocardial Infarction Ann. Pharmacother., October 1, 2003; 37(10): 1465 - 1477. [Abstract] [Full Text] [PDF]
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R. J. Adams, M. I. Chimowitz, J. S. Alpert, I. A. Awad, M. D. Cerqueria, P. Fayad, and K. A. Taubert Coronary Risk Evaluation in Patients With Transient Ischemic Attack and Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the Stroke Council and the Council on Clinical Cardiology of the American Heart Association/American Stroke Association Circulation, September 9, 2003; 108(10): 1278 - 1290. [Full Text] [PDF]
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 J. Morrell Initiating antiplatelet therapy in diabetes: a PCO view The British Journal of Diabetes & Vascular Disease, September 1, 2003; 3(5): 349 - 353. [Abstract] [PDF]
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R. J. Adams, M. I. Chimowitz, J. S. Alpert, I. A. Awad, M. D. Cerqueria, P. Fayad, and K. A. Taubert Coronary Risk Evaluation in Patients With Transient Ischemic Attack and Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the Stroke Council and the Council on Clinical Cardiology of the American Heart Association/American Stroke Association Stroke, September 1, 2003; 34(9): 2310 - 2322. [Full Text] [PDF]
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J. Dallongeville, J. Yarnell, P. Ducimetiere, D. Arveiler, J. Ferrieres, M. Montaye, G. Luc, A. Evans, A. Bingham, B. Hass, et al. Fish Consumption Is Associated With Lower Heart Rates Circulation, August 19, 2003; 108(7): 820 - 825. [Abstract] [Full Text] [PDF]
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D. S.H. Bell Heart Failure: The frequent, forgotten, and often fatal complication of diabetes Diabetes Care, August 1, 2003; 26(8): 2433 - 2441. [Abstract] [Full Text] [PDF]
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P. Greenland and J. M. Gaziano Selecting Asymptomatic Patients for Coronary Computed Tomography or Electrocardiographic Exercise Testing N. Engl. J. Med., July 31, 2003; 349(5): 465 - 473. [Full Text] [PDF]
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P. Giannuzzi, H. Saner, H. Bjornstad, P. Fioretti, M. Mendes, A. Cohen-Solal, L. Dugmore, R. Hambrecht, I. Hellemans, H. McGee, et al. Secondary Prevention Through Cardiac Rehabilitation: Position Paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology Eur. Heart J., July 1, 2003; 24(13): 1273 - 1278. [Abstract] [Full Text] [PDF]
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D. S. Jacoby and D. J. Rader Renin-Angiotensin System and Atherothrombotic Disease: From Genes to Treatment Arch Intern Med, May 26, 2003; 163(10): 1155 - 1164. [Abstract] [Full Text] [PDF]
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J. A. Spertus, M. J. Radford, N. R. Every, E. F. Ellerbeck, E. D. Peterson, and H. M. Krumholz Challenges and opportunities in quantifying the quality of care for acute myocardial infarction: Summary from the acute myocardial infarction working group of the American heart association/American college of cardiology first scientific forum on quality of care and outcomes research in cardiovascular disease and stroke J. Am. Coll. Cardiol., May 7, 2003; 41(9): 1653 - 1663. [Full Text] [PDF]
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 S. Ghosh and W. S. Aronow Utilization of Lipid-Lowering Drugs in Elderly Persons With Increased Serum Low-Density Lipoprotein Cholesterol Associated With Coronary Artery Disease, Symptomatic Peripheral Arterial Disease, Prior Stroke, or Diabetes Mellitus Before and After an Educational Program on Dyslipidemia Treatment J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2003; 58(5): M432 - 435. [Abstract] [Full Text] [PDF]
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S. M. Grundy N-3 Fatty Acids: Priority for Post-Myocardial Infarction Clinical Trials Circulation, April 15, 2003; 107(14): 1834 - 1836. [Full Text] [PDF]
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J. A. Spertus, M. J. Radford, N. R. Every, E. F. Ellerbeck, E. D. Peterson, and H. M. Krumholz Challenges and Opportunities in Quantifying the Quality of Care for Acute Myocardial Infarction: Summary From the Acute Myocardial Infarction Working Group of the American Heart Association/American College of Cardiology First Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Circulation, April 1, 2003; 107(12): 1681 - 1691. [Full Text] [PDF]
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 T. A. Denton, G. C. Fonarow, K. A. LaBresh, and A. Trento Secondary prevention after coronary bypass: the American Heart Association "Get with the Guidelines" program Ann. Thorac. Surg., March 1, 2003; 75(3): 758 - 760. [Full Text] [PDF]
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 P.V. Ylostalo, E. Ek, J. Laitinen, and M.L. Knuuttila Optimism and Life Satisfaction as Determinants for Dental and General Health Behavior--Oral Health Habits Linked to Cardiovascular Risk Factors Journal of Dental Research, March 1, 2003; 82(3): 194 - 199. [Abstract] [Full Text] [PDF]
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D. W Raisch, S. S Netravali, and C. L Harris Pharmacoeconomic Implications of Large Multicenter Clinical Trials Ann. Pharmacother., March 1, 2003; 37(3): 447 - 450. [Full Text] [PDF]
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T. A. Pearson, T. L. Bazzarre, S. R. Daniels, J. M. Fair, S. P. Fortmann, B. A. Franklin, L. B. Goldstein, Y. Hong, G. A. Mensah, J. F. Sallis Jr, et al. American Heart Association Guide for Improving Cardiovascular Health at the Community Level: A Statement for Public Health Practitioners, Healthcare Providers, and Health Policy Makers From the American Heart Association Expert Panel on Population and Prevention Science Circulation, February 4, 2003; 107(4): 645 - 651. [Full Text] [PDF]
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D. Mukherjee, P. Lingam, S. Chetcuti, P. M. Grossman, M. Moscucci, A. E. Luciano, and K. A. Eagle Missed Opportunities to Treat Atherosclerosis in Patients Undergoing Peripheral Vascular Interventions: Insights From the University of Michigan Peripheral Vascular Disease Quality Improvement Initiative (PVD-QI2) Circulation, October 8, 2002; 106(15): 1909 - 1912. [Abstract] [Full Text] [PDF]
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 W. PALINSKI and C. NAPOLI The fetal origins of atherosclerosis: maternal hypercholesterolemia, and cholesterol-lowering or antioxidant treatment during pregnancy influence in utero programming and postnatal susceptibility to atherogenesis FASEB J, September 1, 2002; 16(11): 1348 - 1360. [Abstract] [Full Text] [PDF]
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C. N. B. Merz, G. A. Mensah, V. Fuster, P. Greenland, and P. D. Thompson Task Force #5--the role of cardiovascular specialists as leaders in prevention: from training to champion J. Am. Coll. Cardiol., August 21, 2002; 40(4): 641 - 649. [Full Text] [PDF]
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M. Gheorghiade and S. Goldstein {beta}-Blockers in the Post-Myocardial Infarction Patient Circulation, July 23, 2002; 106(4): 394 - 398. [Full Text] [PDF]
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T. A. Pearson, S. N. Blair, S. R. Daniels, R. H. Eckel, J. M. Fair, S. P. Fortmann, B. A. Franklin, L. B. Goldstein, P. Greenland, S. M. Grundy, et al. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases Circulation, July 16, 2002; 106(3): 388 - 391. [Full Text] [PDF]
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 B. Franklin, K. Bonzheim, J. Warren, S. Haapaniemi, N. Byl, and N. Gordon Effects of a Contemporary, Exercise-Based Rehabilitation and Cardiovascular Risk-Reduction Program on Coronary Patients With Abnormal Baseline Risk Factors* Chest, July 1, 2002; 122(1): 338 - 343. [Abstract] [Full Text] [PDF]
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D. J. Callans Management of the Patient Who Has Been Resuscitated From Sudden Cardiac Death Circulation, June 11, 2002; 105(23): 2704 - 2707. [Full Text] [PDF]
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