title: Is it time to repair a Fairly Fast SAAB Convertible? Testing an evidence-based mnemonic for the secondary prevention of cardiovascular disease.
abstract: OBJECTIVE
  Optimising secondary prevention of cardiovascular disease has the greatest potential to reduce recurrent events, yet despite major guidelines there are ongoing treatment gaps. FFSAABC (Fish oils, Fibrates, Statins, Aspirin, Angiotensin converting enzyme inhibitors or angiotensin 2 receptor antagonists, Beta blockers and Clopidogrel) is one mnemonic previously adopted to assist clinicians in remembering medications for use in secondary prevention. The aim of this narrative review is to examine the current evidence base for medications recommended for patients with established cardiovascular disease and the current applicability of this, or a revised mnemonic for their use.
  
  
  METHODS
  Randomised controlled trials and systematic reviews were sought examining Fish oils, Fibrates, Statins, Aspirin, Angiotensin converting enzyme inhibitors or angiotensin 2 receptor antagonists, Beta blockers or Clopidogrel vs placebo in secondary prevention. The emerging evidence base for other contemporary therapies including the P2Y12 inhibitors (ticagrelor and prasugrel) and aldosterone antagonists was also reviewed.
  
  
  RESULTS
  Definitive evidence supports the use of statins, aspirin, angiotensin converting enzyme inhibitors or angiotensin 2 receptor antagonists, and P2Y12 antagonists (clopidogrel, ticagrelor or prasugrel) for the secondary prevention of cardiovascular disease. Aldosterone antagonists have strong evidence in the presence of systolic heart failure. There is a weaker evidence base for the routine use of omega-3 fatty acid supplementation although this therapy carries minimal harms. Fenofibrate reduces cardiovascular events in dyslipidaemic patients, with additional benefits in patients with diabetes.
  
  
  CONCLUSIONS
  Mnemonic upgrading from a Fairly Fast SAAB Convertible to a Fairly Fast SA(2)A(2)B (Fish oils, Fibrate, Statin, Antiplatelets (Aspirin+Other), ACE/ARB, Aldosterone Antagonist, Beta-blocker) may help to ensure patients receive best practice evidence-based pharmacotherapies for the secondary prevention of cardiovascular disease.
authors.affiliation: National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Level 6 Medical Foundation Building, 92-94 Parramatta Rd, Camperdown, NSW 2050, Australia.
authors.forename: Jialiang
authors.initials: J
authors.lastname: Chin
authors.affiliation: National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Level 6 Medical Foundation Building, 92-94 Parramatta Rd, Camperdown, NSW 2050, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia. Electronic address: jordan.fulcher@ctc.usyd.edu.au.
authors.forename: Jordan
authors.initials: J
authors.lastname: Fulcher
authors.affiliation: National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Level 6 Medical Foundation Building, 92-94 Parramatta Rd, Camperdown, NSW 2050, Australia; St Vincent's Hospital, Fitzroy VIC Australia.
authors.forename: Alicia
authors.initials: A
authors.lastname: Jenkins
authors.affiliation: National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Level 6 Medical Foundation Building, 92-94 Parramatta Rd, Camperdown, NSW 2050, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Keech
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004359:Drug Therapy, Combination / Q000379:methods; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D002317:Cardiovascular Agents
keywords: Acute coronary syndrome; Cardiovascular disease; Evidence-based medicine; Pharmacotherapy; Secondary prevention