Clinical Question

What are the most recent guideline recommendations for the management of chronic coronary disease in adults?

Bottom Line

Key changes in the recommendations include shortening the duration of dual antiplatelet therapy and the use of beta blockers in patients with chronic coronary disease, not recommending fish oil or omega-3 fatty acids for primary or secondary prevention, not using e-cigarettes as first-line agents for smoking cessation, and incorporating sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for some patients with chronic coronary disease. (Level of Evidence = 1a)

Synopsis

The guideline states that recommendations are based on literature searches that focused on randomized trials and systematic reviews, but that the authors also commissioned their own systematic reviews as needed. They included 17 women, and only six authors reported consulting for relevant companies and one was on a speakers bureau. The authors helpfully summarize the 10 top take-home messages. They emphasize team-based care that considers social determinants, takes a shared decision-making approach, and emphasizes exercise and a healthy diet.