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A Controlled Trial of Rivaroxaban After Transcatheter Aortic-Valve Replacement Transcatheter Aortic Valve Replacement in Low-Risk Patients With Symptomatic Severe Bicuspid Aortic Valve Stenosis Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients 5-Year Outcomes After TAVR With Balloon-Expandable Versus Self-Expanding Valves: Results From the CHOICE Randomized Clinical Trial 5-Year Outcomes Comparing Surgical Versus Transcatheter Aortic Valve Replacement in Patients With Chronic Kidney Disease 2020 ACC Expert Consensus Decision Pathway on Management of Conduction Disturbances in Patients Undergoing Transcatheter Aortic Valve Replacement A Report of the American College of Cardiology Solution Set Oversight Committee Ascending Aortic Length and Risk of Aortic Adverse Events: The Neglected Dimension Decline in Left Ventricular Ejection Fraction During Follow-Up in Patients With Severe Aortic Stenosis

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JOURNAL：CBSMD Article Link

2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

CBSMD

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Top 10 Take-Home Messages for the Primary Prevention of Cardiovascular Disease

1. The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life.

2. A team-based care approach is an effective strategy for the prevention of cardiovascular disease.Clinicians should evaluate the social determinants of health that affect individuals to inform treatment

decisions.

3. Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation and have a clinician–patient risk discussion before starting on pharmacological therapy, such as anti hypertensive therapy, a statin, or aspirin. In addition, assessing for other risk-enhancing factors can help guide decisions about preventive interventions in select individuals, as can coronary artery calcium scanning.

4. All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, processed meats, refined carbohydrates, and sweetened beverages. For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss.

5. Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity.

6. For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first-line therapy, followed by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-likepeptide-1 receptor agonist.

7. All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit.

8. Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit.

9. Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion.

10. Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg.

10-Year Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimation Tools

1. American College of Cardiology - ASCVD Risk Estimator Plus；
2. ACC & American Heart Association - ASCVD Risk Calculator；
3. Framingham Coronary Heart Disease (CHD) score；
4. Reynolds Risk Scores for men and women.

Abstract

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2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

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