Navigating the Heart's Highway: Effective Management of Coronary Artery Disease
Keywords:
Heart, Coronary artery, Lifestyle, medicationsAbstract
ABSTRACT
Coronary artery disease (CAD) management involves a multifaceted approach aimed at reducing risk factors, improving symptoms, and preventing disease progression. Lifestyle modifications form the foundation of CAD management, emphasizing a healthy diet, regular exercise, smoking cessation, weight management, and stress reduction. Adopting these changes can effectively control blood pressure, lipid levels, and overall cardiovascular health. Medical therapies play a vital role in CAD management. Antiplatelet drugs like aspirin reduce the risk of blood clot formation, while lipid-lowering agents, particularly statins, help lower cholesterol levels and slow atherosclerosis development. Beta-blockers and ACE inhibitors/ARBs are commonly prescribed to control heart rate, blood pressure, and improve heart function. In cases of severe CAD, interventional procedures may be necessary. Percutaneous coronary intervention (PCI) involves inserting a stent into the narrowed artery to restore blood flow, while coronary artery bypass grafting (CABG) creates new pathways to bypass blocked arteries. Secondary prevention is essential for patients with a history of CAD. Regular follow-ups, adherence to prescribed medications, and participation in cardiac rehabilitation programs can significantly reduce the risk of future cardiac events. Efforts to manage CAD extend beyond the individual level. Public health initiatives and community awareness campaigns promote healthy lifestyle choices to prevent CAD on a broader scale. In conclusion, the management of coronary artery disease demands a comprehensive approach, incorporating lifestyle changes, medical therapies, interventional procedures, and secondary prevention strategies. By addressing CAD from multiple angles, healthcare professionals can effectively reduce its impact, improve patient outcomes, and enhance the overall cardiovascular health of affected individuals.
Keywords: Heart, Coronary artery, Lifestyle, medications.
Downloads
Introduction
Coronary artery disease (CAD), a complex and insidious cardiovascular condition, poses a significant threat to public health worldwide. This chronic disorder arises from the progressive buildup of fatty plaques within the coronary arteries, impairing blood flow to the heart muscle and compromising its function. As the leading cause of heart attacks, angina, and other life-threatening cardiac events, CAD demands a comprehensive and descriptive approach to its management . The prevalence of CAD is staggering, affecting millions of individuals across diverse demographics and geographic regions. Its global impact is evident in the rising tide of cardiovascular-related deaths, making CAD a focal point of concern for healthcare providers, policymakers, and researchers alike. Understanding the complexities of CAD management is crucial to curbing the disease's progression and its devastating consequences on patients' lives . The management of CAD requires a multifaceted approach that encompasses both preventive measures and therapeutic interventions. Emphasizing the significance of lifestyle modifications, healthcare professionals advocate for healthy dietary choices, regular physical activity, smoking cessation, stress reduction, and weight management . These fundamental changes not only address specific risk factors but also promote overall cardiovascular health, laying the groundwork for effective CAD management. In conjunction with lifestyle adjustments, medical therapies play a pivotal role in CAD management. Medications, such as antiplatelet agents, lipid-lowering drugs, beta-blockers, and angiotensin-converting enzyme (ACE) inhibitors, are tailored to address individual risk profiles and mitigate the progression of CAD. By controlling blood clot formation, reducing cholesterol levels, managing blood pressure, and enhancing heart function, these pharmacological interventions contribute to improved patient outcomes and a reduced risk of cardiovascular events [5, 7, 8]. For patients with more severe CAD or in cases where medical therapy alone is insufficient, interventional procedures become essential. Percutaneous coronary intervention (PCI), involving the use of stents to open narrowed arteries, and coronary artery bypass grafting (CABG), creating alternative blood pathways through surgical grafts, offer potential solutions to restore blood flow and alleviate symptoms. These procedures are often instrumental in providing relief and extending the lives of patients with advanced CAD . However, CAD management extends beyond isolated treatments. Secondary prevention, involving regular follow-ups, medication adherence, and participation in cardiac rehabilitation programs, plays a crucial role in sustaining positive outcomes and preventing disease recurrence. The comprehensive and descriptive nature of CAD management ensures a holistic approach to patient care, addressing individual needs, and fostering a sense of empowerment in patients as they take charge of their heart health. The management of coronary artery disease demands a comprehensive and descriptive approach that encompasses preventive measures, medical therapies, interventional procedures, and ongoing support . By adopting a patient-centered approach and promoting a heart-healthy lifestyle, healthcare professionals can effectively combat CAD's devastating impact and improve the quality of life for those affected by this intricate cardiovascular condition. This descriptive management strategy not only addresses the immediate challenges of CAD but also holds the promise of a healthier and more resilient cardiac future for individuals and communities worldwide [12-14].
Lifestyle Modifications
Lifestyle modifications are integral to the management of coronary artery disease. By making these positive changes, individuals can reduce risk factors, improve cardiovascular health, and enhance overall well-being [15-17]. A holistic approach that combines lifestyle modifications with medical therapies and ongoing support from healthcare professionals can significantly improve outcomes for individuals living with CAD. Lifestyle modifications are a fundamental component of the management of coronary artery disease (CAD). These changes aim to reduce risk factors, improve cardiovascular health, and prevent disease progression [18, 19]. Here are the key lifestyle modifications recommended for individuals with CAD:
Healthy Diet: Adopting a heart-healthy diet is crucial in managing CAD. Emphasize a diet rich in fruits, vegetables, whole grains, and lean proteins, such as fish, poultry, and legumes [20, 21]. Reduce the intake of saturated and trans fats, found in processed foods, fried items, and high-fat dairy products. Minimize the consumption of sugary beverages and foods high in added sugars. Instead, opt for healthy fats like those found in avocados, nuts, and olive oil [22, 23].
Regular Physical Activity: Engaging in regular physical activity is essential for managing CAD. Aim for at least 150 minutes of moderate-intensity aerobic exercise, such as brisk walking, cycling, or swimming, per week [24, 25]. Alternatively, 75 minutes of vigorous-intensity exercise is also beneficial. Incorporate strength training exercises at least two days a week to improve muscle strength and overall fitness [26, 27].
Smoking Cessation: Smoking is a significant risk factor for CAD. Quitting smoking is one of the most impactful lifestyle changes individuals can make to reduce the risk of heart-related complications [28, 29]. Seek support from healthcare providers, counseling, or smoking cessation programs to successfully quit smoking [30, 31].
Weight Management: Maintaining a healthy weight is crucial for managing CAD and reducing strain on the heart [32, 33]. Achieve and sustain a body mass index (BMI) within the recommended range through a combination of healthy eating and regular physical activity [34, 35].
Stress Reduction: Chronic stress can negatively impact cardiovascular health. Engage in stress-reducing activities such as meditation, yoga, deep breathing exercises, or hobbies that promote relaxation and mental well-being [36, 37].
Limit Alcohol Consumption: Moderate alcohol consumption may have some cardiovascular benefits [38, 39]. However, excessive alcohol intake can be harmful and increase the risk of heart problems. For individuals with CAD, limiting alcohol intake is recommended [40, 41].
Medication Adherence: In addition to lifestyle modifications, individuals with CAD are often prescribed medications to control risk factors and manage the disease [42, 43]. It is crucial to adhere to the prescribed medications, such as antiplatelet drugs, statins, beta-blockers, and ACE inhibitors/ARBs, as they play a significant role in reducing the risk of cardiovascular events [44, 45].
Regular Monitoring and Follow-Up: Regular medical check-ups and monitoring are essential to assess disease progression and the effectiveness of lifestyle modifications and medications [46, 47]. Healthcare providers can adjust treatment plans based on individual responses and changing risk profiles [46, 48-50].
Medical Therapies
It is essential for individuals with CAD to adhere to their prescribed medication regimen and maintain regular follow-up with healthcare providers to monitor the effectiveness of treatment and adjust medications as needed [51-53]. Medical therapies, in conjunction with lifestyle modifications and other interventions, form a comprehensive approach to managing coronary artery disease and reducing the risk of cardiovascular events [54, 55]. Medical therapies for coronary artery disease (CAD) play a crucial role in reducing symptoms, preventing complications, and improving outcomes. These therapies target various risk factors and disease processes associated with CAD [56, 57]. Here are the key medical treatments commonly used in CAD management:
Antiplatelet Therapy: Antiplatelet drugs, particularly aspirin, are commonly prescribed for individuals with CAD. Aspirin inhibits platelet aggregation and clot formation, reducing the risk of blood clots that can lead to heart attacks or stroke [56, 58, 59]. In some cases, dual antiplatelet therapy (aspirin combined with another antiplatelet medication like clopidogrel) may be recommended, especially after percutaneous coronary intervention (PCI) with stent placement [60, 61].
Lipid-Lowering Agents (Statins): Statins are a class of medications prescribed to lower cholesterol levels, particularly low-density lipoprotein cholesterol (LDL-C) [62, 63]. By inhibiting an enzyme involved in cholesterol production, statins reduce plaque formation in the arteries, slow down atherosclerosis progression, and lower the risk of cardiovascular events. Statins have been shown to significantly reduce the incidence of heart attacks and strokes in individuals with CAD [64, 65].
Beta-Blockers: Beta-blockers are used to manage various heart conditions, including CAD. These medications block the effects of adrenaline on the heart, leading to a reduction in heart rate and blood pressure [66, 67]. By doing so, beta-blockers decrease the workload on the heart, improve angina symptoms, and help prevent arrhythmias. They are particularly beneficial for individuals with a history of heart attacks or heart failure [67, 68].
ACE Inhibitors and ARBs: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are prescribed to manage hypertension and improve heart function in individuals with CAD [69-71]. These medications relax blood vessels, reduce blood pressure, and decrease the strain on the heart. Additionally, ACE inhibitors have been shown to have cardioprotective effects and are beneficial in reducing the risk of heart failure [72, 73].
Nitroglycerin: Nitroglycerin is a vasodilator medication commonly used to relieve angina (chest pain) in individuals with CAD [72, 74, 75]. It works by dilating the coronary arteries and improving blood flow to the heart. Nitroglycerin is available in various forms, including sublingual tablets, sprays, and patches, for acute and long-term angina management [76, 77].
Calcium Channel Blockers: Calcium channel blockers are another class of medications used to manage angina and hypertension in individuals with CAD [76, 78-80]. These drugs relax and widen the blood vessels, which improves blood flow to the heart and reduces the workload on the heart muscle [78, 81, 82].
Other Medications: Additional medications may be prescribed based on individual patient needs and specific risk factors. These may include medications to control diabetes, manage heart rhythm disorders, or address other comorbid conditions [81, 83, 84].
Interventional Procedures
Interventional procedures are performed by interventional cardiologists in specialized catheterization laboratories (cath labs) under local anesthesia and mild sedation [83, 85, 86]. The choice of procedure depends on the extent and location of coronary artery disease, the presence of comorbid conditions, and individual patient factors [87]. These procedures have revolutionized the treatment of CAD, providing life-saving interventions and significantly improving the quality of life for individuals with severe coronary artery disease [88]. Interventional procedures are an integral part of the management of coronary artery disease (CAD), particularly in cases of severe coronary artery blockages that are not adequately controlled by lifestyle modifications and medications [89, 90]. These procedures aim to restore blood flow to the heart and alleviate symptoms such as chest pain (angina). Here are the main interventional procedures used in CAD management:
Percutaneous Coronary Intervention (PCI) or Coronary Angioplasty: Percutaneous coronary intervention, commonly known as angioplasty, is a minimally invasive procedure used to treat narrowed or blocked coronary arteries [91-93]. During PCI, a catheter with a deflated balloon is inserted into the affected artery. The balloon is then inflated, compressing the plaque against the arterial walls and widening the narrowed segment. This action improves blood flow to the heart muscle [94]. In many cases, a stent (a small, mesh-like tube) is also placed in the artery to keep it open after the balloon is deflated and removed. The stent remains in place, providing ongoing support to the arterial walls and reducing the risk of re-narrowing (restenosis) [95, 96].
Drug-Eluting Stents (DES): Drug-eluting stents are a specialized type of stent used in PCI [97, 98]. These stents are coated with medication that is gradually released over time. The medication helps inhibit cell proliferation and reduces the risk of restenosis after the procedure [99]. DES has significantly improved long-term outcomes compared to bare-metal stents [99-101].
Bioresorbable Vascular Scaffold (BVS): Bioresorbable vascular scaffolds, also known as bioresorbable stents, are an innovative type of stent designed to be gradually absorbed by the body over time [102-104]. Once the scaffold dissolves, the artery regains its natural flexibility and function. BVS has shown promising results in some cases, but its use is currently less widespread than traditional drug-eluting stents, and further research is ongoing [105, 106].
Rotational Atherectomy: Rotational atherectomy is a technique used in complex cases where the plaque buildup is hard or calcified [107]. In this procedure, a high-speed rotating burr is used to drill through the plaque and create a wider channel in the artery. The debris is then removed from the artery using a suction catheter [107].
Coronary Artery Bypass Grafting (CABG): Coronary artery bypass grafting is a surgical procedure used to create alternative routes for blood flow when multiple coronary arteries are severely blocked or when PCI is not feasible [108]. In CABG, healthy blood vessels from other parts of the body, typically the chest or leg, are harvested and grafted onto the coronary arteries, bypassing the blockages. This restores blood flow to the heart muscle, relieving angina and improving overall heart function [108].
Secondary Prevention
Secondary prevention for coronary artery disease is a comprehensive approach aimed at reducing the risk of recurrent cardiac events and improving the overall well-being of individuals diagnosed with CAD [109]. By emphasizing medication adherence, lifestyle modifications, regular medical follow-ups, participation in cardiac rehabilitation, self-management education, and psychosocial support, healthcare professionals can significantly enhance the long-term outcomes and quality of life for individuals living with CAD [110]. Secondary prevention for coronary artery disease (CAD) focuses on reducing the risk of recurrent cardiovascular events and improving long-term outcomes in individuals who have already been diagnosed with CAD or experienced a cardiac event [109]. This phase of CAD management aims to prevent further complications and enhance the overall quality of life for affected individuals. The key components of secondary prevention for CAD include:
Medication Adherence: Ensuring strict adherence to prescribed medications is critical in secondary prevention. Medications commonly prescribed for CAD include antiplatelet drugs (such as aspirin or dual antiplatelet therapy), statins to lower cholesterol levels, beta-blockers to control heart rate and blood pressure, ACE inhibitors or ARBs for blood pressure management, and other medications tailored to the individual's specific needs and risk profile [111].
Lifestyle Modifications: Lifestyle changes initiated during the primary prevention phase should continue and be reinforced during secondary prevention [112]. Encouraging a heart-healthy diet, regular physical activity, smoking cessation, stress reduction, and weight management remains crucial. Individuals should be educated on the benefits of these changes and provided with ongoing support to sustain positive habits [113].
Regular Medical Check-Ups and Follow-Up: Frequent medical check-ups and follow-up visits with healthcare providers are essential in monitoring CAD progression and assessing the effectiveness of treatments [114]. Healthcare professionals can adjust medications, address emerging risk factors, and provide guidance to optimize cardiac health. Regular monitoring of blood pressure, cholesterol levels, blood glucose (for individuals with diabetes), and overall cardiovascular health is vital [115].
Cardiac Rehabilitation Programs: Cardiac rehabilitation programs are designed to support individuals recovering from a cardiac event or undergoing cardiac interventions [116]. These programs typically include supervised exercise sessions tailored to the individual's condition, education on heart-healthy lifestyle habits, psychological support, and stress management techniques. Participation in cardiac rehabilitation has been shown to reduce the risk of future cardiovascular events and improve overall cardiovascular health [116].
Education and Self-Management: Empowering individuals with CAD to actively manage their condition is a key aspect of secondary prevention. Patients should receive education on their medications, risk factors, warning signs of potential complications, and strategies to respond to symptoms like angina or shortness of breath appropriately. Self-management skills are crucial in recognizing and acting promptly on any changes in their condition [116, 117].
Managing Comorbid Conditions: Many individuals with CAD may have other medical conditions, such as diabetes, hypertension, or obesity, that require management [118, 119]. Addressing these comorbid conditions through appropriate medical treatment and lifestyle modifications is essential to optimize overall health and reduce cardiovascular risk [120].
Psychosocial Support: Psychosocial support is vital in secondary prevention, as individuals with CAD may experience anxiety, depression, or other emotional challenges related to their condition. Providing emotional support and access to counseling or support groups can help individuals cope with the psychological aspects of living with CAD [121].
Conclusion
The management of coronary artery disease (CAD) requires a comprehensive and multifaceted approach aimed at reducing risk factors, improving symptoms, preventing complications, and enhancing overall cardiovascular health. Lifestyle modifications form the foundation of CAD management, emphasizing healthy dietary choices, regular physical activity, smoking cessation, stress reduction, and weight management. Medical therapies play a crucial role in controlling risk factors and halting disease progression. Medications such as antiplatelet agents, statins, beta-blockers, ACE inhibitors/ARBs, and nitroglycerin contribute significantly to reducing cardiovascular events and improving quality of life for individuals with CAD. Interventional procedures, including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), are instrumental in restoring blood flow to the heart and alleviating angina in severe cases. Furthermore, secondary prevention strategies, such as medication adherence, cardiac rehabilitation, regular follow-up visits, and self-management education, are vital in preventing recurrent events and empowering individuals to actively participate in their cardiac health. By combining lifestyle modifications, medical therapies, interventional procedures, and secondary prevention efforts, healthcare professionals can effectively manage CAD, reduce its burden on global health, and enhance the longevity and well-being of individuals living with this prevalent cardiovascular condition. Public awareness, early detection, and ongoing research are essential in driving advancements and improving outcomes for CAD management in the future.
References
P.A.J.C.J.o.t.A.S.o.N. McCullough, Coronary artery disease, 2(3) (2007) 611-616.
M. Maqbool, F. Bekele, G.J.B.C.T. Fekadu, Therapy, Treatment strategies against triple-negative breast cancer: an updated review, (2022) 15-24.
P. Libby, P.J.C. Theroux, Pathophysiology of coronary artery disease, 111(25) (2005) 3481-3488.
M. Zehravi, M. Maqbool, I.J.I.j.o.a.m. Ara, health, Polycystic ovary syndrome and infertility: an update, 34(2) (2021) 1-9.
V. Fuster, L. Badimon, J.J. Badimon, J.H.J.N.E.j.o.m. Chesebro, The pathogenesis of coronary artery disease and the acute coronary syndromes, 326(4) (1992) 242-250.
R. Maqbool, M. Maqbool, M. Zehravi, I.J.I.j.o.a.m. Ara, health, Menstrual distress in females of reproductive age: a literature review, 34(2) (2021) 11-17.
N.R. Hertzer, E.G. Beven, J.R. Young, P.J. O'Hara, W. Ruschhaupt 3rd, R.A. Graor, V.G. Dewolfe, L.C.J.A.o.s. Maljovec, Coronary artery disease in peripheral vascular patients. A classification of 1000 coronary angiograms and results of surgical management, 199(2) (1984) 223.
M. Zehravi, M. Maqbool, I.J.I.J.o.A.M. Ara, Health, Correlation between obesity, gestational diabetes mellitus, and pregnancy outcomes: an overview, 33(6) (2021) 339-345.
C. Shao, J. Wang, J. Tian, Y.-d.J.C.A.D.T. Tang, D. Discovery, Coronary artery disease: from mechanism to clinical practice, (2020) 1-36.
U. Ralapanawa, R.J.J.o.e. Sivakanesan, g. health, Epidemiology and the magnitude of coronary artery disease and acute coronary syndrome: a narrative review, 11(2) (2021) 169.
M. Zehravi, M. Maqbool, I.J.I.J.o.A.M. Ara, Health, Depression and anxiety in women with polycystic ovarian syndrome: a literature survey, 33(6) (2021) 367-373.
R. Bauersachs, U. Zeymer, J.-B. Brière, C. Marre, K. Bowrin, M.J.C.t. Huelsebeck, Burden of coronary artery disease and peripheral artery disease: a literature review, 2019 (2019).
M. Abdar, W. Książek, U.R. Acharya, R.-S. Tan, V. Makarenkov, P.J.C.m. Pławiak, p.i. biomedicine, A new machine learning technique for an accurate diagnosis of coronary artery disease, 179 (2019) 104992.
R.J. Lihite, M. Lahkar, S. Das, D. Hazarika, M. Kotni, M. Maqbool, S.J.A.j.o.m. Phukan, A study on adverse drug reactions in a tertiary care hospital of Northeast India, 53(2) (2017) 151-156.
A. Barham, R. Ibraheem, S.e.H.J.B.C.D. Zyoud, Cardiac self-efficacy and quality of life in patients with coronary heart disease: a cross-sectional study from Palestine, 19(1) (2019) 1-12.
M. Zehravi, M. Maqbool, I.J.O.H. Ara, Healthy lifestyle and dietary approaches to treating polycystic ovary syndrome: a review, 3(1) (2022) 60-65.
M. Zehravi, M. Maqbool, I.J.I.J.o.A.M. Ara, Health, Teenage menstrual dysfunction: an overview, 35(1) (2022) 15-19.
Y. Higashi, S. Gautam, P. Delafontaine, S.J.G.H. Sukhanov, I. Research, IGF-1 and cardiovascular disease, 45 (2019) 6-16.
D. Ornish, S.E. Brown, J. Billings, L. Scherwitz, W.T. Armstrong, T.A. Ports, S.M. McLanahan, R.L. Kirkeeide, K. Gould, R.J.T.L. Brand, Can lifestyle changes reverse coronary heart disease?: The Lifestyle Heart Trial, 336(8708) (1990) 129-133.
J.C. Rutledge, D.A. Hyson, D. Garduno, D.A. Cort, L. Paumer, C.T.J.J.o.C.R. Kappagoda, Prevention, Lifestyle modification program in management of patients with coronary artery disease: the clinical experience in a tertiary care hospital, 19(4) (1999) 226-234.
A. Majeed, R. Bashir, S. Farooq, M.J.J.o.D.D. Maqbool, Therapeutics, Preparation, characterization and applications of nanoemulsions: An insight, 9(2) (2019) 520-527.
S. Khan, M. Cleanthis, J. Smout, M. Flather, G.J.E.J.o.V. Stansby, E. Surgery, Life-style modification in peripheral arterial disease, 29(1) (2005) 2-9.
M. Mohd, M. Maqbool, M.A. Dar, I.J.J.o.D.D. Mushtaq, Therapeutics, Polycystic ovary syndrome, a modern epidemic: an overview, 9(3) (2019) 641-644.
E.B. Winzer, F. Woitek, A.J.J.o.t.A.H.A. Linke, Physical activity in the prevention and treatment of coronary artery disease, 7(4) (2018) e007725.
M. Maqbool, I. Gani, M.A.J.A.J.o.P.R. Dar, Development, Anti-diabetic effects of some medicinal plants in experimental animals: a review, 7(1) (2019) 66-69.
J. Claes, R. Buys, W. Budts, N. Smart, V.A.J.E.j.o.p.c. Cornelissen, Longer-term effects of home-based exercise interventions on exercise capacity and physical activity in coronary artery disease patients: A systematic review and meta-analysis, 24(3) (2017) 244-256.
I. Ara, M. Maqbool, I.J.I.J.o.C.R.i.P. Gani, Pharmacology, Reproductive Health of Women: implications and attributes, (2022) 8-18.
I. Goldenberg, M. Jonas, A. Tenenbaum, V. Boyko, S. Matetzky, A. Shotan, S. Behar, H. Reicher-Reiss, B.I.P.S.G.J.A.o.i. medicine, Current smoking, smoking cessation, and the risk of sudden cardiac death in patients with coronary artery disease, 163(19) (2003) 2301-2305.
R. Bashir, M. Maqbool, I. Ara, M.J.C. Zehravi, An In sight into Novel Drug Delivery System: In Situ Gels, 11(1) (2021) 6.1-6.7.
J. Ludvig, B. Miner, M.J.J.A.H.J. Eisenberg, Smoking cessation in patients with coronary artery disease, 149(4) (2005) 565-572.
M. Maqbool, G. Fekadu, D. Dugassa, F. Bekele, E. Turi, D.J.A.o.N. Simegnew, The pattern of substance abuse in the psychiatry department of a tertiary care of Srinagar hospital, Jammu and Kashmir, India, 7(4) (2020).
P.A. Ades, P.D.J.P.i.c.d. Savage, Potential benefits of weight loss in coronary heart disease, 56(4) (2014) 448-456.
G. Fekadu, F. Bekele, K. Bekele, S. Hanbisa, G. Belay, M.J.C.T. Maqbool, Drug use evaluation of beta-blockers in medical wards of Nedjo general hospital, Western Ethiopia, 2020 (2020).
Q.R. Pack, J.P. Rodriguez-Escudero, R.J. Thomas, P.A. Ades, C.P. West, V.K. Somers, F. Lopez-Jimenez, The prognostic importance of weight loss in coronary artery disease: a systematic review and meta-analysis, Mayo Clinic Proceedings, Elsevier, 2014, pp. 1368-1377.
I. Ara, M. Zehravi, M. Maqbool, I.J.J.o.P.R. Gani, R.S.J.-D.d. org/10.47363/JPRSR/, A review of recent developments and future challenges in the implementation of universal health coverage policy framework in some countries, 127 (2022).
A. Michalsen, P. Grossman, N. Lehmann, N.T. Knoblauch, A. Paul, S. Moebus, T. Budde, G.J.J.P. Dobos, psychosomatics, Psychological and quality-of-life outcomes from a comprehensive stress reduction and lifestyle program in patients with coronary artery disease: results of a randomized trial, 74(6) (2005) 344-352.
M. Maqbool, D. Dugassa, G.J.A.o.N. Fekadu, Adverse drug reactions of antiepileptic drugs in the neurology department of a tertiary care hospital, Srinagar, Jammu & Kashmir, India, 8(2) (2021).
M.J. Mathews, L. Liebenberg, E.H.J.N.j. Mathews, The mechanism by which moderate alcohol consumption influences coronary heart disease, 14 (2015) 1-12.
M. Maqbool, M. Zehravi, R. Maqbool, I.J.C. Ara, An overview about treatment of gestational diabetes mellitus: A short communication, 11(3) (2021) 12.1-12.5.
C. Matsumoto, M.D. Miedema, P. Ofman, J.M. Gaziano, H.D.J.J.o.c.r. Sesso, prevention, An expanding knowledge of the mechanisms and effects of alcohol consumption on cardiovascular disease, 34(3) (2014) 159-171.
M. Zehravi, M. Maqbool, I.J.I.J.o.A.M. Ara, Health, Unfolding the mystery of premenstrual syndrome (PMS): an overview, 35(1) (2022) 9-13.
T.M. Maddox, P.M.J.C.o.i.c. Ho, Medication adherence and the patient with coronary artery disease: challenges for the practitioner, 24(5) (2009) 468-472.
I. Ara, M. Maqbool, B. Bukhari, N. Ara, T.A.J.I.J.o.R.i.P.S. Hajam, Technology, Present status, standardization and safety issues with herbal drugs, 1(3) (2020) 95-101.
S. Baroletti, H.J.C. Dell'Orfano, Medication adherence in cardiovascular disease, 121(12) (2010) 1455-1458.
I. Ara, M. Maqbool, I.J.I.J.o.C.R.i.P. Gani, Pharmacology, Neuroprotective Activity of Herbal Medicinal Products: A Review, (2022) 1-10.
C.B. Mendez, N.C. Salum, C. Junkes, L.N. Amante, C.M.L.J.R.l.-a.d.e. Mendez, Mobile educational follow-up application for patients with peripheral arterial disease, 27 (2019).
M. Maqbool, S. Rasool, M.A. Dar, R. Bashir, M.J.P. Khan, Hepatotoxicity and Hepatoprotective agents: A Mini review, 7(9) (2019) 34-40.
D.T. Zhou, O. Oektedalen, S. Shawarira-Bote, B.J.H.A.-R. Stray-Pedersen, P. Care, Changes in coronary heart disease risk profiles of HIV patients in Zimbabwe over 9 months: a follow-up study, (2016) 165-174.
M. Maqbool, A.M. Dar, S. Rasool, M.J.J.o.A.P.S. Khan, Research, Curious case of drug resistant malaria and artemisinin compounds in the modern era, (2019) 1-4.
M. Maqbool, M.J.I.P.M. Zehravi, Neuromodulation, Neuroprotective role of polyphenols in treatment of neurological disorders: A review, 1(1) (2021).
G.J. Hankey, P.E. Norman, J.W.J.J. Eikelboom, Medical treatment of peripheral arterial disease, 295(5) (2006) 547-553.
R.A. Rayan, I. Zafar, H. Rajab, M.A.M. Zubair, M. Maqbool, S.J.M.L.A.f.S. Hussain, I. Processing, Impact of IoT in Biomedical Applications Using Machine and Deep Learning, (2022) 339-360.
I. Ara, M. Maqbool, G. Fekadu, T.A. Hajam, M.A.J.J.o.A.P.S. Dar, Research, Pharmaceutical significance of Nigella sativa L., a wonder herb, 3(4) (2020) 04-13.
B.D.S.G.J.N.E.J.o. Medicine, A randomized trial of therapies for type 2 diabetes and coronary artery disease, 360(24) (2009) 2503-2515.
R. Maqbool, M. Maqbool, M. Zehravi, I.J.I.J.o.A.M. Ara, Health, Acute neurological conditions during pregnancy and their management: a review, 33(6) (2021) 357-366.
G.C. Fonarow, A. Gawlinski, S. Moughrabi, J.H.J.T.A.j.o.c. Tillisch, Improved treatment of coronary heart disease by implementation of a Cardiac Hospitalization Atherosclerosis Management Program (CHAMP), 87(7) (2001) 819-822.
M. Maqbool, M. Zehravi, R. Maqbool, I.J.C. Ara, Study of adverse drug reactions in pulmonary medicine department of a Tertiary care hospital, Srinagar, Jammu & Kashmir, India, 11(2) (2021) 8.1-8.5.
H. Tran, S.S.J.J. Anand, Oral antiplatelet therapy in cerebrovascular disease, coronary artery disease, and peripheral arterial disease, 292(15) (2004) 1867-1874.
M. Zehravi, R. Maqbool, M. Maqbool, I.J.J.o.P.R.I. Ara, To Identify Patterns of Drug Usage among Patients Who Seek Care in Psychiatry Outpatient Department of a Tertiary Care Hospital in Srinagar, Jammu and Kashmir, India, 33(31A) (2021) 135-140.
N. Clappers, M. Brouwer, F.J.H. Verheugt, Antiplatelet treatment for coronary heart disease, 93(2) (2007) 258-265.
M.J.J.o.A.P.S. Maqbool, Research, Evaluation of drug utilization pattern in the pediatric department of a Tertiary Care Hospital in Srinagar, Jammu & Kashmir, India, (2019) 6-9.
U. Rauch, J. Osende, J. Chesebro, V. Fuster, D. Vorchheimer, K. Harris, P. Harris, D. Sandler, J. Fallon, S.J.A. Jayaraman, Statins and cardiovascular diseases: the multiple effects of lipid-lowering therapy by statins, 153(1) (2000) 181-189.
C.G. Mihos, A.M. Pineda, O.J.P.r. Santana, Cardiovascular effects of statins, beyond lipid-lowering properties, 88 (2014) 12-19.
D. Tousoulis, M. Charakida, E. Stefanadi, G. Siasos, G. Latsios, C.J.I.j.o.c. Stefanadis, Statins in heart failure. Beyond the lipid lowering effect, 115(2) (2007) 144-150.
M. Maqbool, I.J.J.o.P.P. Gani, C. Medicine, Utilization of statins in reducing comorbidities of diabetes mellitus: A systematic review, 4(4) (2018).
S. Paravastu, D. Mendonca, A.J.E.j.o.v. Da Silva, e. surgery, Beta blockers for peripheral arterial disease, 38(1) (2009) 66-70.
I. Ara, M. Maqbool, I.J.I.J.o.C.R.i.P. Gani, Pharmacology, Specificity and Personalized medicine: a novel approach to Cancer management, (2022) 11-20.
M. Chonchol, M. Benderly, U.J.N.D.T. Goldbourt, Beta-blockers for coronary heart disease in chronic kidney disease, 23(7) (2008) 2274-2279.
D.P. Leong, J.J. McMurray, P.G. Joseph, S.J.J.o.t.A.C.o.C. Yusuf, From ACE inhibitors/ARBs to ARNIs in coronary artery disease and heart failure (part 2/5), 74(5) (2019) 683-698.
E.L. Gillespie, C.M. White, M. Kardas, M. Lindberg, C.I.J.D.c. Coleman, The impact of ACE inhibitors or angiotensin II type 1 receptor blockers on the development of new-onset type 2 diabetes, 28(9) (2005) 2261-2266.
M.A. Dar, M. Maqbool, I. Gani, I.J.I.J.o.C.R.i.P. Ara, Pharmacology, Menstruation hygiene and related issues in adolescent girls: A brief commentary, (2023) 1-5.
V. Hoang, M. Alam, D. Addison, F. Macedo, S. Virani, Y.J.C.d. Birnbaum, therapy, Efficacy of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers in coronary artery disease without heart failure in the modern statin era: a meta-analysis of randomized-controlled trials, 30 (2016) 189-198.
M. Maqbool, M.J.P. Khan, Hypertension and Pregnancy: an important issue, 7(8) (2019) 71-78.
R. GORLIN, N. BRACHFELD, C. MACLEOD, P.J.C. BOPP, Effect of nitroglycerin on the coronary circulation in patients with coronary artery disease or increased left ventricular work, 19(5) (1959) 705-718.
I. Ara, M. Maqbool, M. Zehravi, I.J.A.J.C.B. Gani, Herbs Boosting Immunity in Covid-19: An Overview, 3(3) (2020) 289-94.
Z.H. Sawan, H.M. Soliman, A.E.A. Mostafa, R.A.J.T.E.J.o.H.M. Kamel, A Review on Nitroglycerin: Present and Future, 91(1) (2023) 4972-4974.
M. Zehravi, M. Maqbool, I.J.T.I.J.o.N. Ara, Dietetics, An overview about safety surveillance of adverse drug reactions and pharmacovigilance in India, (2021) 408-418.
E. Sorbets, P.G. Steg, R. Young, N. Danchin, N. Greenlaw, I. Ford, M. Tendera, R. Ferrari, B. Merkely, A.J.E.H.J. Parkhomenko, β-blockers, calcium antagonists, and mortality in stable coronary artery disease: an international cohort study, 40(18) (2019) 1399-1407.
M. Maqbool, I. Ara, I.J.I.J.o.C.R.i.P. Gani, Pharmacology, The Story of Polycystic Ovarian Syndrome: A Challenging Disorder with Numerous Consequences for Females of Reproductive Age, (2022) 19-31.
R. Bashir, M. Maqbool, M. Zehravi, I.J.A.J.C.S.B. Ara, Utilization of herbal cosmetics: A brief overview, 3 (2021) 277-288.
A.K. Malakar, D. Choudhury, B. Halder, P. Paul, A. Uddin, S.J.J.o.c.p. Chakraborty, A review on coronary artery disease, its risk factors, and therapeutics, 234(10) (2019) 16812-16823.
M. Zehravi, M. Maqbool, I.J.A.J.o.C. Ara, Section B, Curcumin–A promising phytocompound of immense potential, 3 (2021) 271.
S. Jia, Y. Liu, J.J.C.A.D.T. Yuan, D. Discovery, Evidence in guidelines for treatment of coronary artery disease, (2020) 37-73.
M.A. Dar, M. Maqbool, I.J.J.o.E.o.M. Ara, D. Sciences, Metformin and Other Sulfonylureas for Glycemic Control in Type 2 Diabetic Patients at a Tertiary Care Hospital in Jammu & Kashmir, (2023) 197-201.
N. Chen, L. Chen, S. Jiang, Z. Wang, T.J.E. Liu, T. Medicine, Predictive value of P‑selectin and endothelin‑1 for vascular restenosis after interventional procedures for peripheral artery disease, 17(5) (2019) 3907-3912.
M.A. Dar, M. Maqbool, I.J.J.o.E.o.M. Ara, D. Sciences, Patterns of Drug Use in Geriatric Patients at a Tertiary Care Teaching Hospital in Jammu and Kashmir, (2023) 182-186.
R. Loffroy, N. Falvo, C. Galland, L. Fréchier, F. Ledan, M. Midulla, O.J.F.i.C.M. Chevallier, Intravascular ultrasound in the endovascular treatment of patients with peripheral arterial disease: current role and future perspectives, 7 (2020) 551861.
M.A. Dar, M. Maqbool, I.J.J.o.E.o.M. Ara, D. Sciences, Prescription Pattern of Antibiotics in Pulmonary Ward of a Tertiary Care Hospital, Jammu and Kashmir, (2023) 171-175.
S.K. Arramraju, R.K. Janapati, E.S. Kumar, G.R.J.I.H.J. Mandala, National interventional council data for the year 2018-India, 72(5) (2020) 351-355.
M.M. Willie, M.J.A.S.R.P. Maqbool, Access to public health services in South Africa’s rural Eastern Cape Province, 1(2) (2023) 35-54.
F. Darmoch, M.C. Alraies, Y. Al‐Khadra, H. Moussa Pacha, D.S. Pinto, E.A.J.J.o.t.A.H.A. Osborn, Intravascular ultrasound imaging–guided versus coronary angiography–guided percutaneous coronary intervention: a systematic review and meta‐analysis, 9(5) (2020) e013678.
S. Mumtaz, F. Behram, D.K. Jadoon, M. Maqbool, S.A.A. Shah, U.F.J.N. Khawaja, PATTERN OF DRUG USE IN THE DERMATOLOGY DEPARTMENT OF A HOSPITAL FOR COMMON SKIN CONDITIONS, 20(16) (2022) 2804.
M. Maqbool, N. Nasir, S.J.I.A.J.O.P.S. Mustafa, Polycystic in ovarian syndrome and its various treatment strategies, 5(9) (2018) 8470-8478.
S. Völz, B. Redfors, O. Angerås, D. Ioanes, J. Odenstedt, S. Koul, I. Valeljung, C. Dworeck, R. Hofmann, E.J.E.H.J. Hansson, Long-term mortality in patients with ischaemic heart failure revascularized with coronary artery bypass grafting or percutaneous coronary intervention: insights from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR), 42(27) (2021) 2657-2664.
F. Li, G.-W. Shi, X.-L. Yu, R.-X. Song, J.-Q. Xiao, H.-M. Huang, L.-M. Li, L.-Y. Zhang, C. Gong, G.-J.J.B.C.D. Cai, Safety and efficacy of coronary angiography and percutaneous coronary intervention via distal transradial artery access in the anatomical snuffbox: a single-centre prospective cohort study using a propensity score method, 22(1) (2022) 1-8.
M. Maqbool, A. Naeem, S.J.I.A.J.o.P.S. Aamer, Diabetes mellitus and its various management strategies in practice, 5(8) (2018) 8163-+.
J. Aoki, K.J.C.I. Tanabe, Therapeutics, Mechanisms of drug-eluting stent restenosis, 36 (2021) 23-29.
M. Maqbool, S. Tariq, S.J.I.A.J.o.P.S. Amjad, Prescribing practices in pediatrics and drug utilization studies promoting pediatric health, 5(8) (2018) 8070-8076.
S. Kuramitsu, S. Sonoda, K. Ando, H. Otake, M. Natsuaki, R. Anai, Y. Honda, K. Kadota, Y. Kobayashi, T.J.C.i. Kimura, therapeutics, Drug-eluting stent thrombosis: current and future perspectives, 36 (2021) 158-168.
M.V. Madhavan, J.P. Howard, A. Naqvi, O. Ben-Yehuda, B. Redfors, M. Prasad, B. Shahim, M.B. Leon, S. Bangalore, G.W.J.E.H.J. Stone, Long-term follow-up after ultrathin vs. conventional 2nd-generation drug-eluting stents: a systematic review and meta-analysis of randomized controlled trials, 42(27) (2021) 2643-2654.
M. Maqbool, S. Javed, A.A.J.I.A.J.O.P.S. Bajwa, Assessment OF pain management IN postoperative cases using different scales and questionnaires, 6(1) (2019) 983-987.
H. Jinnouchi, S. Torii, A. Sakamoto, F.D. Kolodgie, R. Virmani, A.V.J.N.R.C. Finn, Fully bioresorbable vascular scaffolds: lessons learned and future directions, 16(5) (2019) 286-304.
S.-W. Baek, D.-S. Kim, D.H. Song, H.B. Kim, S. Lee, J.H. Kim, J.-K. Lee, Y.J. Hong, C.G. Park, D.K.J.B.R. Han, Reduced restenosis and enhanced re-endothelialization of functional biodegradable vascular scaffolds by everolimus and magnesium hydroxide, 26(1) (2022) 1-17.
M. Maqbool, W. Shabbir, S.J.I.A.J.O.P.S. Aamir, Adverse events of blood transfusion and blood safety in clinical practice, 5(8) (2018) 8254-8259.
A. Chaus, B.F.J.C.D. Uretsky, Therapy, Bioresorbable Vascular Scaffolds: a Dissolving Dream?, 37(1) (2023) 1-3.
M. Maqbool, U. Ikram, A.J.I.A.J.O.P.S. Anwar, Adverse drug reaction monitoring and occurrence in drugs used in pulmonary disorders, 5(8) (2018) 8060-8065.
S.K. Sharma, M.I. Tomey, P.S. Teirstein, A.S. Kini, A.B. Reitman, A.C. Lee, P. Généreux, J.W. Chambers, C.L. Grines, S.I.J.C.C.I. Himmelstein, North American expert review of rotational atherectomy, 12(5) (2019) e007448.
F. Bouisset, E. Barbato, K. Reczuch, S. Dobrzycki, M. Meyer-Gessner, E. Bressollette, G. Cayla, T. Lhermusier, W. Zajdel, M.J.E.J.o.E.i.C.w.t.W.G.o.I.C.o.t.E.S.o.C. Ferenc, Clinical outcomes of PCI with rotational atherectomy: the European multicentre Euro4C registry, 16(4) (2020) e305-e312.
K. Jin, S. Khonsari, R. Gallagher, P. Gallagher, A.M. Clark, B. Freedman, T. Briffa, A. Bauman, J. Redfern, L.J.E.J.o.C.N. Neubeck, Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review and meta-analysis, 18(4) (2019) 260-271.
K. Rees, A. Takeda, N. Martin, L. Ellis, D. Wijesekara, A. Vepa, A. Das, L. Hartley, S.J.C.D.o.S.R. Stranges, Mediterranean‐style diet for the primary and secondary prevention of cardiovascular disease, (3) (2019).
S.K. Zyryanov, S.B. Fitilev, A.V. Vozzhaev, I.I. Shkrebniova, N.N. Shindryaeva, D.A. Klyuev, L.N. Stepanyan, N.N. Landyshev, Y.G.J.R.R.i.P. Voronko, Medication adherence in patients with stable coronary artery disease in primary care, 6(2) (2020) 97-103.
T.A. Wadden, J.S. Tronieri, M.L.J.A.p. Butryn, Lifestyle modification approaches for the treatment of obesity in adults, 75(2) (2020) 235.
G.K. Bhatti, A.P. Reddy, P.H. Reddy, J.S.J.F.i.a.n. Bhatti, Lifestyle modifications and nutritional interventions in aging-associated cognitive decline and Alzheimer’s disease, 11 (2020) 369.
P. Jepma, H.T. Jorstad, M. Snaterse, G. Ter Riet, H. Kragten, S. Lachman, M. Minneboo, S.M. Boekholdt, R.J. Peters, W.S.J.H. Op Reimer, Lifestyle modification in older versus younger patients with coronary artery disease, 106(14) (2020) 1066-1072.
M.-E. Piché, P. Poirier, A. Marette, P. Mathieu, V. Levesque, K. Bibeau, E. Larose, J.-P.J.M.S. Despres, R. Disorders, Benefits of 1-year lifestyle modification program on exercise capacity and diastolic function among coronary artery disease men with and without type 2 diabetes, 17(3) (2019) 149-159.
C. Ge, J. Ma, Y. Xu, Y.-J. Shi, C.-H. Zhao, L. Gao, J. Bai, Y. Wang, Z.-J. Sun, J.J.J.o.g.c.J. Guo, Predictors of adherence to home-based cardiac rehabilitation program among coronary artery disease outpatients in China, 16(10) (2019) 749.
P.C. Hong, K.J. Chen, Y.C. Chang, S.M. Cheng, H.H.J.J.o.N.S. Chiang, Effectiveness of theory‐based health information technology interventions on coronary artery disease self‐management behavior: a clinical randomized waitlist‐controlled trial, 53(4) (2021) 418-427.
S.V. Arnold, D.L. Bhatt, G.W. Barsness, A.L. Beatty, P.C. Deedwania, S.E. Inzucchi, M. Kosiborod, L.A. Leiter, K.J. Lipska, J.D.J.C. Newman, Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association, 141(19) (2020) e779-e806.
B.J. Turner, C.S. Hollenbeak, M. Weiner, T. Ten Have, S.S.J.A.o.i.m. Tang, Effect of unrelated comorbid conditions on hypertension management, 148(8) (2008) 578-586.
P.K. Newland, R. Lorenz, C. Budhathoki, M.P.J.C.n.r. Jensen, The presence of symptoms with comorbid conditions in individuals with multiple sclerosis (MS), 25(5) (2016) 532-548.
R. Ferrari, H. Abergel, I. Ford, K.M. Fox, N. Greenlaw, P.G. Steg, D. Hu, M. Tendera, J.-C. Tardif, C.i.J.I.j.o. cardiology, Gender-and age-related differences in clinical presentation and management of outpatients with stable coronary artery disease, 167(6) (2013) 2938-2943.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Mashooq Ahmad Mir, Abrar Bashir Malik, Mohd Altaf Dar
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The journal allows the author(s) to hold the copyright without restrictions and will retain publishing rights without restrictions.
The submitted papers are assumed to contain no proprietary material unprotected by patent or patent application; responsibility for technical content and for protection of proprietary material rests solely with the author(s) and their organizations and is not the responsibility of the journal. The main (first/corresponding) author is responsible for ensuring that the article has been seen and approved by all the other authors. It is the responsibility of the author to obtain all necessary copyright release permissions for the use of any copyrighted materials in the manuscript prior to the submission.
What are my rights as an author?
It is important to check the policy for the journal to which you are submitting or publishing to establish your rights as
Author. Journal's standard policies allow the following re-use rights:
- The journal allows the author(s) to hold the copyright without restrictions.
- The journal allows the author(s) to obtain publishing rights without restrictions.
- You may do whatever you wish with the version of the article you submitted to the journal.
- Once the article has been accepted for publication, you may post the accepted version of the article on your own personal website, your department's website or the repository of your institution without any restrictions.
- You may not post the accepted version of the article in any repository other than those listed above (i.e. you may not deposit in the repository of another institution or a subject-matter repository) until 12 months after publication of the article in the journal.
- You may use the published article for your own teaching needs or to supply on an individual basis to research colleagues, provided that such supply is not for commercial purposes.
