Secondary Prevention The treatment of the patient does not end with PCI; secondary prevention measures are a critical component of patient management. Important secondary prevention measures were presented in detail in the 2006 AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease 562 and have recently been updated in the AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update. 805 The reader is referred to this document for detailed discussions of secondary prevention. Among the important recommendations are the following: Lipid management with lifestyle modification (Class I; Level of Evidence: B)805 807 and statin therapy are recommended. (Level of Evidence: A)344,806,808 810,810a An adequate statin dose should be employed which reduces low-density lipoprotein cholesterol to 100 mg/dL AND achieves at least a 30% lowering of low-density lipoprotein cholesterol. (Class I; Level of Evidence: C)806 810,810a It is reasonable to treat patients with statin therapy which lowers low-density lipoprotein cholesterol to 70 mg/dL in very high risk* patients. (Class IIa; Level of Evidence: C)345,808 810,810a,811,812 Patients who have triglycerides 200 mg/dL should be treated with statins to lower non high-density lipoprotein cholesterol to 130 mg/dL. (Class I; Level of Evidence: B)344,809,810,866 In patients who are very high risk* and have triglycerides 200 mg/dL, a non high-density lipoprotein cholesterol goal of 100 mg/dL is reasonable. (Class IIa; Level of Evidence: C)344,809,810,866 Blood pressure control with lifestyle modification (Class I; Level of Evidence: B)813 817 and pharmacotherapy (Class I; Level of Evidence: A),805,813,818,819 with the goal of blood pressure 140/90 mm Hg. Diabetes management (eg, lifestyle modification and pharmacotherapy), coordinated with the patient s pri- mary care physician and/or endocrinologist. (Class I; Level of Evidence: C)805 Advising patients on the need for complete smoking cessation. 