Objective To make an individualized treatment plan for a premature menopause female who was diagnosed as stable coronary heart disease with the symptom of frequent palpitation after physical activity for over 1 month..
Methods Seven clinical problems were put forward after assessing the patient's health state. We searched The Cochrane Library (Issue 2, 2005 ) , evidence-based medicine reviews (EMBtk) (1991 - 2005 ) , and MEDLINE (1991 - 2005 ) databases. Systematic review, meta-analysis and randomized controlled trials about the treatment of coronary heart disease were included. The treatment plan was developed accordingly.
Results After evaluating, thirty-four studies were ehglble. The evidence indicated that three kind of drugs (aspirin, h-blockers and statins), exercise and dietary therapy, and 75mg/d aspirin for secondary prevention, could improve the therapy effect and the prognosis by controlling LDL below 2.6 mmol/L; ACEIs should be used depending on the patient's condition; coronary arteriography and interventional strategy helped little for patients without coronary artery events in recent 3 months, and their cost-effectiveness was lower; hormone replacement therapy even increased the risk of thrombosis. The individualized treatment plan was developed based on the available evidence. After 2 months, the patient's weight declined, the symptom of angina disappeared and the lipidemia reduced to aimed level.
Conclusions The individualized treatment plan based on the high quality evidence and patient's condition is optimal for the short-term treatment of stable coronary heart disease. However, the long-term prognostic benefits need to be confirmed by continuing follow-up.
Citation: Wang Binyou,He Ping,Oong Birong. Evidence-based Treatment for a Patient with Stable Coronary Heart Disease. Chinese Journal of Evidence-Based Medicine, 2006, 06(1): 63-68. doi: Copy