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__NOTOC__
{{Chronic stable angina}}
{{Chronic stable angina}}
'''Editors-In-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:mgibson@perfuse.org] Phone:617-632-7753; {{CZ}}; '''Associate Editors-In-Chief:''' [[John Fani Srour, M.D.]]; Jinhui Wu, MD


==Smoking cessation==
'''Editor-In-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:mgibson@perfuse.org] Phone:617-632-7753; '''Associate Editor(s)-In-Chief:''' {{CZ}}; [[John Fani Srour, M.D.]]; [[WikiDoc Scholars#WikiDoc Scholars with Distinction|Jinhui Wu, M.D.]]; [[Lakshmi Gopalakrishnan|Lakshmi Gopalakrishnan. M.B.B.S.]]


*The 1989 Surgeon General’s report concluded, on the basis of case-control and cohort studies, that '''smoking increased cardiovascular disease mortality by 50%'''. Hence, this is an important component of lifestyle modification.  
==Overview==
Based on the 1989 Surgeon General’s report, that assessed numerous case-control and cohort studies, reported that '''smoking increased cardiovascular disease mortality by 50%'''.<ref name="pmid2494426">Centers for Disease Control (CDC) (1989) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2494426 The Surgeon General's 1989 Report on Reducing the Health Consequences of Smoking: 25 Years of Progress.] ''MMWR Morb Mortal Wkly Rep'' 38 Suppl 2 ():1-32. PMID: [http://pubmed.gov/2494426 2494426]</ref> Cigarette smoking, presumably by hemodynamic consequences of sympathetic neural stimulation and systemic [[catecholamine]] release plays an important role in the pathogenesis of [[coronary artery disease]] and forms a major risk factor for acute cardiovascular events as a consequent to associated increase in [[Coagulopathy|blood coagulability]].<ref name="pmid9180099">Benowitz NL, Gourlay SG (1997) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9180099 Cardiovascular toxicity of nicotine: implications for nicotine replacement therapy.] ''J Am Coll Cardiol'' 29 (7):1422-31. PMID: [http://pubmed.gov/9180099 9180099]</ref> Hence, cigarette smoking is an important reversible risk factor in the pathogenesis of [[CAD]] and cessation of which improves [[Chronic stable angina prognosis|prognosis]] and is associated with a substantial decrease in the risk of mortality.<ref name="pmid8114863">Bartecchi CE, MacKenzie TD, Schrier RW (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8114863 The human costs of tobacco use (1)] ''N Engl J Med'' 330 (13):907-12. [http://dx.doi.org/10.1056/NEJM199403313301307 DOI:10.1056/NEJM199403313301307] PMID: [http://pubmed.gov/8114863 8114863]</ref><ref name="pmid8121461">MacKenzie TD, Bartecchi CE, Schrier RW (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8121461 The human costs of tobacco use (2)] ''N Engl J Med'' 330 (14):975-80. [http://dx.doi.org/10.1056/NEJM199404073301406 DOI:10.1056/NEJM199404073301406] PMID: [http://pubmed.gov/8121461 8121461]</ref><ref name="pmid14583958">Critchley J, Capewell S (2003) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=14583958 Smoking cessation for the secondary prevention of coronary heart disease.] ''Cochrane Database Syst Rev''  (4):CD003041. [http://dx.doi.org/10.1002/14651858.CD003041 DOI:10.1002/14651858.CD003041] PMID: [http://pubmed.gov/14583958 14583958]</ref> In patients with [[Chronic stable angina definition|stable angina pectoris]], '''nicotine replacement therapy''' has shown to be potentially beneficial, despite the associated cardiovascular risks of [[nicotine]] such as increase in [[heart rate]] with a small rise in [[blood pressure]], and may be initiated as early as 2–3 days after [[MI|acute myocardial infarction]] or [[arrhythmias|cardiac arrhythmias]].<ref name="pmid9180099">Benowitz NL, Gourlay SG (1997) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9180099 Cardiovascular toxicity of nicotine: implications for nicotine replacement therapy.] ''J Am Coll Cardiol'' 29 (7):1422-31. PMID: [http://pubmed.gov/9180099 9180099]</ref> '''Nicotine patches''' have been used successfully in [[Chronic stable angina risk assessment in patients with an intermediate or high probability of coronary artery disease|high-risk patients]] without any adverse effects such as aggravation of [[MI]] or [[arrhythmia]].<ref name="pmid9784902">Tzivoni D, Keren A, Meyler S, Khoury Z, Lerer T, Brunel P (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9784902 Cardiovascular safety of transdermal nicotine patches in patients with coronary artery disease who try to quit smoking.] ''Cardiovasc Drugs Ther'' 12 (3):239-44. PMID: [http://pubmed.gov/9784902 9784902]</ref><ref name="pmid8179456"> (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8179456 Nicotine replacement therapy for patients with coronary artery disease. Working Group for the Study of Transdermal Nicotine in Patients with Coronary artery disease.] ''Arch Intern Med'' 154 (9):989-95. PMID: [http://pubmed.gov/8179456 8179456]</ref>


*The cardiovascular effects of [[nicotine]] such as increase in [[heart rate]] with small rises in [[blood pressure]], have provoked some concerns about the use of Nicotine Replacement Therapy (NRT) in patients with [[coronary artery disease]].
==ACC/AHA Guidelines- Cardiovascular Risk Factor Reduction- Smoking Cessation (DO NOT EDIT)<ref name="pmid10351980">Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10351980 ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina).] ''Circulation'' 99 (21):2829-48. [http://circ.ahajournals.org/content/99/21/2829.full.pdf] PMID: [http://pubmed.gov/10351980 10351980]</ref><ref name="pmid12515758">Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS et al. (2003) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12515758 ACC/AHA 2002 guideline update for the management of patients with chronic stable angina--summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina).] ''Circulation'' 107 (1):149-58.[http://content.onlinejacc.org/cgi/reprint/41/1/159.pdf] PMID: [http://pubmed.gov/12515758 12515758]</ref><ref name="pmid17998462">Fraker TD, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. (2007)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17998462 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina.] ''Circulation'' 116 (23):2762-72.[http://content.onlinejacc.org/cgi/reprint/50/23/2264.pdf] PMID: [http://pubmed.gov/17998462 17998462]</ref>==
:*Nicotine patches have been used successfully in heart disease patients without any adverse effects.
:*Similarly, it is suggested that nicotine replacement therapy may be initiated '''as early as 2–3 days after''' acute [[myocardial infarction]] and that it may be used in all patients with [[Chronic stable angina definition|stable angina pectoris]] and cardiac [[arrhythmias]].
 
==ACC / AHA Guidelines for cardiovascular risk factor reduction- Smoking Cessation (DO NOT EDIT)<ref name="pmid10351980">Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10351980 ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina).] ''Circulation'' 99 (21):2829-48. [http://circ.ahajournals.org/content/99/21/2829.full.pdf] PMID: [http://pubmed.gov/10351980 10351980]</ref><ref name="pmid12515758">Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS et al. (2003) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12515758 ACC/AHA 2002 guideline update for the management of patients with chronic stable angina--summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina).] ''Circulation'' 107 (1):149-58.[http://content.onlinejacc.org/cgi/reprint/41/1/159.pdf] PMID: [http://pubmed.gov/12515758 12515758]</ref><ref name="pmid17998462">Fraker TD, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. (2007)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17998462 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina.] ''Circulation'' 116 (23):2762-72.[http://content.onlinejacc.org/cgi/reprint/50/23/2264.pdf] PMID: [http://pubmed.gov/17998462 17998462]</ref>==
{{cquote|
{{cquote|
===Class I===
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]===
'''1.''' Smoking cessation and avoidance of exposure to environmental tobacco smoke at work and home is recommended. Follow-up, referral to special programs, and/or pharmacotherapy (including [[nicotine]] replacement) is recommended, as is a stepwise strategy for smoking cessation (Ask, Advise, Assess, Assist, Arrange). ''(Level of Evidence: B)''}}
'''1.''' Smoking cessation and avoidance of exposure to environmental tobacco smoke at work and home is recommended. Follow-up, referral to special programs, and/or pharmacotherapy (including [[nicotine|nicotine replacement]]) is recommended, as is a stepwise strategy for smoking cessation (Ask, Advise, Assess, Assist, Arrange). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''}}


==Vote on and Suggest Revisions to the Current Guidelines==
==Vote on and Suggest Revisions to the Current Guidelines==
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==Sources==
==Sources==
*Guidelines on the management of stable angina pectoris: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology <ref name="pmid16735367">{{cite journal| author=Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F et al.| title=Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. | journal=Eur Heart J | year= 2006 | volume= 27 | issue= 11 | pages= 1341-81 | pmid=16735367 | doi=10.1093/eurheartj/ehl001 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16735367 [http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-angina-FT.pdf]}} </ref>
*The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina <ref name="pmid10351980">Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10351980 ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina).] ''Circulation'' 99 (21):2829-48. [http://circ.ahajournals.org/content/99/21/2829.full.pdf] PMID: [http://pubmed.gov/10351980 10351980]</ref>
*The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina <ref name="pmid10351980">Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10351980 ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina).] ''Circulation'' 99 (21):2829-48. [http://circ.ahajournals.org/content/99/21/2829.full.pdf] PMID: [http://pubmed.gov/10351980 10351980]</ref>


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*The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina <ref name="pmid17998462">Fraker TD, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. (2007)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17998462 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina.] ''Circulation'' 116 (23):2762-72.[http://content.onlinejacc.org/cgi/reprint/50/23/2264.pdf] PMID: [http://pubmed.gov/17998462 17998462]</ref>
*The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina <ref name="pmid17998462">Fraker TD, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. (2007)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17998462 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina.] ''Circulation'' 116 (23):2762-72.[http://content.onlinejacc.org/cgi/reprint/50/23/2264.pdf] PMID: [http://pubmed.gov/17998462 17998462]</ref>
*Guidelines on the management of stable angina pectoris: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology <ref name="pmid16735367">{{cite journal| author=Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F et al.| title=Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. | journal=Eur Heart J | year= 2006 | volume= 27 | issue= 11 | pages= 1341-81 | pmid=16735367 | doi=10.1093/eurheartj/ehl001 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16735367 [http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-angina-FT.pdf]}} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Revision as of 19:47, 5 September 2011

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4] Phone:617-632-7753; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [5]; John Fani Srour, M.D.; Jinhui Wu, M.D.; Lakshmi Gopalakrishnan. M.B.B.S.

Overview

Based on the 1989 Surgeon General’s report, that assessed numerous case-control and cohort studies, reported that smoking increased cardiovascular disease mortality by 50%.[1] Cigarette smoking, presumably by hemodynamic consequences of sympathetic neural stimulation and systemic catecholamine release plays an important role in the pathogenesis of coronary artery disease and forms a major risk factor for acute cardiovascular events as a consequent to associated increase in blood coagulability.[2] Hence, cigarette smoking is an important reversible risk factor in the pathogenesis of CAD and cessation of which improves prognosis and is associated with a substantial decrease in the risk of mortality.[3][4][5] In patients with stable angina pectoris, nicotine replacement therapy has shown to be potentially beneficial, despite the associated cardiovascular risks of nicotine such as increase in heart rate with a small rise in blood pressure, and may be initiated as early as 2–3 days after acute myocardial infarction or cardiac arrhythmias.[2] Nicotine patches have been used successfully in high-risk patients without any adverse effects such as aggravation of MI or arrhythmia.[6][7]

ACC/AHA Guidelines- Cardiovascular Risk Factor Reduction- Smoking Cessation (DO NOT EDIT)[8][9][10]

“

Class I

1. Smoking cessation and avoidance of exposure to environmental tobacco smoke at work and home is recommended. Follow-up, referral to special programs, and/or pharmacotherapy (including nicotine replacement) is recommended, as is a stepwise strategy for smoking cessation (Ask, Advise, Assess, Assist, Arrange). (Level of Evidence: B)

”

Vote on and Suggest Revisions to the Current Guidelines

Sources

  • The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina [8]
  • TheACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina [9]
  • The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina [10]
  • Guidelines on the management of stable angina pectoris: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology [11]

References

  1. ↑ Centers for Disease Control (CDC) (1989) The Surgeon General's 1989 Report on Reducing the Health Consequences of Smoking: 25 Years of Progress. MMWR Morb Mortal Wkly Rep 38 Suppl 2 ():1-32. PMID: 2494426
  2. ↑ 2.0 2.1 Benowitz NL, Gourlay SG (1997) Cardiovascular toxicity of nicotine: implications for nicotine replacement therapy. J Am Coll Cardiol 29 (7):1422-31. PMID: 9180099
  3. ↑ Bartecchi CE, MacKenzie TD, Schrier RW (1994) The human costs of tobacco use (1) N Engl J Med 330 (13):907-12. DOI:10.1056/NEJM199403313301307 PMID: 8114863
  4. ↑ MacKenzie TD, Bartecchi CE, Schrier RW (1994) The human costs of tobacco use (2) N Engl J Med 330 (14):975-80. DOI:10.1056/NEJM199404073301406 PMID: 8121461
  5. ↑ Critchley J, Capewell S (2003) Smoking cessation for the secondary prevention of coronary heart disease. Cochrane Database Syst Rev (4):CD003041. DOI:10.1002/14651858.CD003041 PMID: 14583958
  6. ↑ Tzivoni D, Keren A, Meyler S, Khoury Z, Lerer T, Brunel P (1998) Cardiovascular safety of transdermal nicotine patches in patients with coronary artery disease who try to quit smoking. Cardiovasc Drugs Ther 12 (3):239-44. PMID: 9784902
  7. ↑ (1994) Nicotine replacement therapy for patients with coronary artery disease. Working Group for the Study of Transdermal Nicotine in Patients with Coronary artery disease. Arch Intern Med 154 (9):989-95. PMID: 8179456
  8. ↑ 8.0 8.1 Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina). Circulation 99 (21):2829-48. [1] PMID: 10351980
  9. ↑ 9.0 9.1 Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS et al. (2003) ACC/AHA 2002 guideline update for the management of patients with chronic stable angina--summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). Circulation 107 (1):149-58.[2] PMID: 12515758
  10. ↑ 10.0 10.1 Fraker TD, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. (2007)2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation 116 (23):2762-72.[3] PMID: 17998462
  11. ↑ Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F; et al. (2006). %5bhttp://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-angina-FT.pdf%5d "Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology" Check |url= value (help). Eur Heart J. 27 (11): 1341–81. doi:10.1093/eurheartj/ehl001. PMID 16735367.


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