<s> [INST] <<SYS>> You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, say that you don't know. Please don't share false information. <</SYS>>What are the TAKE-HOME MESSAGES FOR CHRONIC
CORONARY DISEASE [/INST] 1. Emphasis is on team-based, patient-centered care that
considers social determinants of health along with
associated costs while incorporating shared decisionmaking in risk assessment, testing, and treatment.
2. Nonpharmacologic therapies, including healthy dietary habits and exercise, are recommended for all
patients with chronic coronary disease (CCD).
3. Patients with CCD who are free from contraindications
are encouraged to participate in habitual physical activity, including activities to reduce sitting time and
to increase aerobic and resistance exercise.
Cardiac rehabilitation for eligible patients provides
significant cardiovascular benefits, including
decreased morbidity and mortality outcomes.
4. Use of sodium glucose cotransporter 2 inhibitors and
glucagon-like peptide-1 receptor agonists are recommended for select groups of patients with CCD,
including groups without diabetes.
5. New recommendations for beta-blocker use in patients with CCD: (a) Long-term beta-blocker therapy is
not recommended to improve outcomes in patients
with CCD in the absence of myocardial infarction in
the past year, left ventricular ejection fraction #50%,
or another primary indication for beta-blocker therapy; and (b) Either a calcium channel blocker or beta
blocker is recommended as first-line antianginal
therapy.
6. Statins remain first line therapy for lipid lowering in
patients with CCD. Several adjunctive therapies (eg,
ezetimibe, PCSK9 [proprotein convertase subtilisin/
kexin type 9] inhibitors, inclisiran, bempedoic acid)
may be used in select populations, although clinical
outcomes data are unavailable for novel agents such
as inclisiran.
7. Shorter durations of dual antiplatelet therapy are safe
and effective in many circumstances, particularly
when the risk of bleeding is high and the ischemic risk
is low to moderate.
8. The use of nonprescription or dietary supplements,
including fish oil and omega-3 fatty acids or vitamins,
is not recommended in patients with CCD given the
lack of benefit in reducing cardiovascular events.
9. Routine periodic anatomic or ischemic testing without
a change in clinical or functional status is not recommended for risk stratification or to guide therapeutic
decision-making in patients with CCD.
10. Although e-cigarettes increase the likelihood of successful smoking cessation compared with nicotine
replacement therapy, because of the lack of long-term
safety data and risks of sustained use, e-cigarettes are
not recommended as first-line therapy for smoking
cessation. </s>