Introduction to secondary prevention of atherosclerotic cardiovascular events

Patients with atherosclerotic cardiovascular disease (ASCVD) include those who have been diagnosed with:

• ST elevation myocardial infarction (STEMI)
• non–ST elevation acute coronary syndrome (NSTEACS)
• an acute cerebrovascular event
• stable angina
• peripheral artery disease.

While the acute management of each of these conditions is different, all patients with ASCVD require similar long-term drug and nondrug management. Specific considerations for the secondary prevention of cerebrovascular events are addressed in Secondary prevention of ischaemic stroke and transient ischaemic attack.

Secondary prevention of atherosclerotic cardiovascular events is usually managed by the general practitioner; however, multiple clinicians may be involved, particularly during the transition from acute care to chronic management. Clear allocation of responsibilities (eg specifying the clinician responsible for adjusting the dosage of drug therapy) is crucial to ensure patients receive optimal therapy and ongoing management.

Encourage long-term adherence to both drug therapy and lifestyle measures. Models of care that encourage patient participation, such as self-monitoring of blood pressure, may improve adherence.

Cardiac rehabilitation programs improve morbidity, mortality and quality of life following a cardiovascular event or diagnosis of ASCVDWoodruffe, 2015; see Cardiac rehabilitation programs for more information.