At first glance it appears illogical to include coronary artery disease (CAD) as a risk factor for itself, but it does make clinical sense.
People who have existing angina, atherosclerosis or who have had a previous heart attack are more likely than the average person to suffer from further clinical events linked to their atherosclerosis.
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Procedures such as coronary angioplasty (opening blocked vessels by means of balloons) and coronary surgery also predict a risk of future problems.
So pronounced is this effect, that lipid-lowering medication is recommended for patients with established CAD or related atherosclerotic disorder at much lower threshold cholesterol levels than for those without such a history.
These people are in a separate category requiring much more vigorous and individually tailored intervention.
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