New Canadian guidelines to help treat and prevent heart disease
Ottawa — The Canadian Cardiovascular Society’s (CCS) new guidelines will help physicians to use a critically important therapy to treat and prevent heart attacks and strokes in Canada.
"The CCS Guidelines for the Use of Antiplatelet Therapy in the Outpatient Setting are the first and only of their kind in the world,” says Dr. Alan Bell, co-chair of the CCS antiplatelet guidelines committee. “Unlike other disease-based documents, this paper is treatment-based. It includes heart attack and stroke prevention, as well as many other vascular conditions.”
“These new CCS guidelines are important because they will provide physicians with specific recommendations to manage challenging questions such as, when to continue or interrupt dual antiplatelet therapy in patients who have acute coronary syndrome or a stent implantation or need a surgery or diagnostic procedures,” explains Dr. Jean-Francois Tanguay, co-chair of the CCS antiplatelet guideline committee.
The guidelines address antiplatelet therapy, such as the use of acetylsalicylic acid (ASA), in a comprehensive manner. They cover all relevant diseases or conditions, including special situations like diabetes and pregnancy, and they give clinicians “one-stop shopping” on how to use this critically important prevention strategy. Used appropriately, antiplatelet therapy can reduce the risk of heart attack, stroke or death by up to 25 per cent.
The CCS Guidelines for the Use of Antiplatelet Therapy in the Outpatient Setting, published in the May/June issue of the Canadian Journal of Cardiology, makes a number of recommendations including some that go against common belief:
Lifetime use of low dose ASA or other antiplatelet medications is recommended for all patients who have had a heart attack, stroke or peripheral artery disease.
ASA is not recommended as a primary prevention therapy for people who have not had a heart attack or stroke or other vascular disease, even if they have diabetes or other risk factors.
The use of ibuprofen is strongly discouraged for people taking ASA for secondary heart attack or stroke prevention. Ibuprofen, as well as other anti-inflammatory drugs, blocks the protective effect of ASA, and puts this group of people at increased risk of heart attack and stroke.
Antiplatelet therapies, such as ASA use, are widely used to prevent cardiovascular disease. Antiplatelet agents act to help prevent blood clots that can lead to a stroke or heart attack.
Until now, there has been a lack of comprehensive guidelines focusing on the use of antiplatelet medications in patients with or at risk for of cardiovascular disease.
The CCS antiplatelet guidelines committee – Canadian multispecialists and family physicians – reviewed existing disease-based guidelines and peer-reviewed literature to develop the guidelines, which include recommendations for the use of all antiplatelet medications including new and yet-to-be-approved agents.
The CCS has also developed tools to help integrate these guidelines into clinical practice. These include an easy-to-access smart phone “app”, educational podcasts, a pocket reference card and nationally-accredited continuing medical education programs.
The Use of Antiplatelet Therapy in the Outpatient Setting is aimed at all health care professionals who treat patients with or at risk of all forms of vascular disease.
Heart disease and stroke are two of the three leading causes of death in Canada and account for at least one third of all deaths. They are the leading cause of hospitalization in Canada.
About the Canadian Cardiovascular Society
The Canadian Cardiovascular Society (CCS) is the national voice for cardiovascular physicians and scientists and is more than 1900 members strong. The CCS mission is to promote cardiovascular health and care through: knowledge translation, including dissemination of research and encouragement of best practices; professional development; and leadership in health policy. (www.ccs.ca)
About the Canadian Journal of Cardiology
The Canadian Journal of Cardiology is the official journal of the Canadian Cardiovascular Society. It is a vehicle for the national and international dissemination of new knowledge in cardiology and cardiovascular science, particularly serving as a major venue for the results of Canadian cardiovascular research and Society guidelines. The Journal publishes original reports of clinical and basic research relevant to cardiovascular medicine as well as editorials, review articles, case reports, and papers on health outcomes, policy research, ethics, medical history, and political issues affecting practice.
For more information:
Canadian Cardiovascular Society
613-569-3407 ext. 304