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Previous Volume 348:1456-1463 April 10, 2003 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 71-year-old woman who had a myocardial infarction five years previously and underwent coronary-artery bypass surgery six months ago visits a primary care physician. She had no complications after surgery, but intraoperative transesophageal echocardiography revealed a grade V atheroma in the descending aorta. She has no cardiac or neurologic symptoms but notes that she feels depressed and has difficulty concentrating. She had . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Changes in Lifestyle

            Smoking Cessation

            Cardiac Rehabilitation

            Psychosocial Management

Pharmacologic Interventions

            Antiplatelet Drugs

            Beta-Blockers and Angiotensin-Converting–Enzyme Inhibitors

            Lipid-Lowering Agents

            Control of Blood Pressure and Diabetes

            Treatment of Depression

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Division of General Internal Medicine (M.E.C.), the Center for Complementary and Integrative Medicine (M.E.C.), and the Department of Cardiothoracic Surgery (O.W.I.), Weill Medical College, Cornell University, New York.

Address reprint requests to Dr. Charlson at Weill Medical College, 525 E. 68th St., Box 46, New York, NY 10021, or at mecharl@med.cornell.edu.

Related Letters:

Care after Coronary-Artery Bypass Surgery
Sorokin R., Charlson M., Isom O. W.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:307, Jul 17, 2003. Correspondence

This article has been cited by other articles:

• Shah, S. J., Waters, D. D., Barter, P., Kastelein, J. J.P., Shepherd, J., Wenger, N. K., DeMicco, D. A., Breazna, A., LaRosa, J. C. (2008). Intensive Lipid-Lowering With Atorvastatin for Secondary Prevention in Patients After Coronary Artery Bypass Surgery. J Am Coll Cardiol 51: 1938-1943 [Abstract] [Full Text]  
• Ferguson, T. B. Jr (2004). Preoperative calcium-channel blockade in cardiac surgery: the good, the bad, the issues. J. Thorac. Cardiovasc. Surg. 127: 622-624 [Full Text]  
• Sorokin, R., Charlson, M., Isom, O. W. (2003). Care after Coronary-Artery Bypass Surgery. NEJM 349: 307-307 [Full Text]