The Secondary Prevention of Coronary Artery Disease

Abstract

Disease prevention has been targeted as a national goal,[1] declared a medical imperative,[2] and identified as a major component of healthcare reform plans. As the nation's leading cause of morbidity and mortality and a major contributor to healthcare costs,[3] coronary artery disease represents an excellent preventive target. In 1995 the estimated medical care cost in disability due to cardiovascular disease was $137.7 billion.[4] Because surgery and angioplasty relieve symptoms for an average of about 5 years,[5–7] and one third of patients suffer sudden and unexpected death despite treatment,[8] preventive strategies in patients with established coronary disease, often termed secondary prevention, have emerged as a national priority.