目的:“2023年AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠心病患者管理指南”提供了更新并巩固了自“2012年ACCF/AHA/ACP/AATS/PCNA/SCAI/STS《稳定性缺血性心脏病患者诊断和管理指南》”和相应的“2014年ACCF/ASCNA《ACCF/ACP/ACATHA稳定性心脏病
方法:从2021年9月至2022年5月进行了全面的文献检索。临床研究,系统评价和荟萃分析,以及对人类参与者进行的其他证据被确定为从MEDLINE(通过PubMed)以英文发表,EMBASE,Cochrane图书馆,医疗保健研究和质量机构,以及与本指南相关的其他选定数据库。
■本指南为慢性冠心病患者的管理提供了以证据为基础和以患者为中心的方法。考虑健康的社会决定因素,并纳入共同决策和基于团队的护理原则。相关主题包括治疗决策的一般方法,指南指导的管理和治疗,以减少症状和未来的心血管事件,关于慢性冠心病患者血运重建的决策,特殊人群的管理建议,患者随访和监测,证据缺口,以及未来需要研究的领域。如果适用,基于成本效益数据的可用性,还为临床医生提供了成本价值建议.以前发布的指南中的许多建议已经更新了新的证据,并且在发布的数据支持下创建了新的建议。
The \"2023 AHA/ACC/ACCP/ASPC/NLA/PCNA
Guideline for the Management of Patients With Chronic Coronary Disease\" provides an update to and consolidates new evidence since the \"2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS
Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease\" and the corresponding \"2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease.\"
A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline.
This
guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions,
guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published
guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.