Stable Coronary Artery Disease (2nd Edition)
The previous clinical practice guidelines for the management of stable angina were issued in 2010. Since then, there have been advances in both diagnostic and therapeutic strategies in the management of this progressive disease. Therefore, it is timely for the publication of this CPG, with a title that is now evolved from stable angina to that of stable coronary artery disease (SCAD).
Atherosclerosis is a systemic vascular disease, but it is in the coronary arteries where this progressive disease exerts its most serious effects which can significantly affect morbidity and mortality.
Clinical manifestation of SCAD, by means of stable angina, has long been the pointwhereby an individual begins to seek medical attention. However, the combination of earlier screening by an increasingly greater number of the general population at risk of coronary artery disease has seen more patients being diagnosed with the subclinical SCAD. The high prevalence of risk factors of cardiovascular disease in Malaysia, including diabetes, hypertension, dyslipidaemia and smoking, and the emergence of better diagnostic equipment have both contributed to this effect.
In both subclinical and clinically evident SCAD, there are now new drugs and non-drug interventions available, which are now more readily available compared to when this last CPG was published. In addition, new clinical evidence have emerged on these new therapies. In this respect, the publication of this CPG, which reviews published research on these new therapies and strategies, is timely.
The management of SCAD has to be tailored carefully to an individual, as the right therapeutic strategies often improves symptoms. This CPG reviews most available treatment options in Malaysia and makes recommendations on strategies that can improve both the patients’ clinical outcomes and quality of life.
Finally, I would like to thank Dr Jeyamalar Rajadurai and the multidisciplinary team on the expert panel who have worked hard to put this CPG together, as well as the external reviewers of this CPG. I believe this CPG will be a relevant document for every practicing healthcare professional who manages patients with SCAD.
Datuk Dr. Noor Hisham Bin Abdullah
Director-General of Health Malaysia
Ministry of Health Malaysia
Statement of intent:
This guideline was developed to be a guide for best clinical practice, based on the best available evidence at the time of development. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to this guideline does not necessarily lead to the best clinical outcome in individual patient care. Every health care provider is responsible for the management of his/her unique patient based on the clinical presentation and management options available locally.
Review of the Guideline:
This guideline is issued in 2018 and available for download. It will be reviewed in 2023 or earlier if important new evidence becomes available.