Overview of Stable Ischemic Heart Disease (SIHD)

Study Notes

Overview of Stable Ischemic Heart Disease (SIHD)

Also referred to as Chronic Coronary Disease (CCD), Coronary Artery Disease (CAD), Coronary Heart Disease (CHD), or Coronary Artery Atherosclerosis.
Characterized by inadequate blood supply to the myocardium (heart muscle).

Importance of SIHD

Leading cause of death globally for both men and women.
Over 20 million adults in the U.S. are diagnosed with Chronic Coronary Disease (CCD).
Prevalence of CHD increases significantly with age: 22% of men and 13% of women aged 60-79, rising to 34% and 22% respectively for those 80 years and older.

Risk Factors for SIHD

Non-modifiable:
- Age
- Genetics or family history of premature ischemic heart disease (IHD).
Modifiable:
- Smoking
- Hyperlipidemia: Important to maintain cholesterol below 150 mg/dL while addressing secondary causes (e.g., lifestyle changes).
SIHD is included in the broader category of clinical Atherosclerotic Cardiovascular Disease (ASCVD).

New Considerations in First-Line Therapy

Colchicine 0.5 mg daily can be used to reduce recurrent atherosclerotic cardiovascular disease (ASCVD) events.
- Acts as an anti-inflammatory agent.
- Has a long half-life and a narrow therapeutic index, making its use prone to drug-drug interactions particularly with CYP 3A4 and p-glycoprotein substrates.
- Contraindicated in patients with an estimated glomerular filtration rate (eGFR) less than 40.

Peripheral Atherosclerosis

Significant morbidity, mortality, and impairment of quality of life are associated with peripheral atherosclerosis.
Especially affected areas include lower limbs.
Risk factors include:
- Age (particularly over 75)
- Family history of Peripheral Artery Disease (PAD)
- Depression
- Other atherosclerotic risk factors like diabetes, hypertension, and hyperlipidemia.
- Chronic Kidney Disease (CKD) or End-Stage Kidney Disease (ESKD).
- Presence of microvascular diseases (retinopathy, neuropathy, nephropathy).

Symptoms and Complications of SIHD

May present asymptomatically or with symptoms.
Claudication: Characterized by fatigue, discomfort, cramping, or pain in lower extremities, consistently induced by exercise and relieved by rest within 10 minutes.
Acute Limb Ischemia (ALI): A severe condition resulting from sudden lack of blood flow with critical symptoms.

Description

This quiz covers the essentials of Stable Ischemic Heart Disease (SIHD), also known as Chronic Coronary Disease (CCD). Learn about its significance as a leading cause of death, risk factors, and the distinction between non-modifiable and modifiable risks. Develop a deeper understanding of its impact on the population, especially among older adults.