Definitions
What is primary prevention of cardiovascular disease?
A patient who has has risk of ASCVD, but has not had an ASCVD event
Ischemic heart disease and coronary heart disease are the same thing
TRUE
50% or more
A 72-year-old male has no hx of an ASCVD event. His PMH includes diabetes and hypertension. Should he be on aspirin therapy for primary prevention?
NO - He is >70, so should not be administered on a routine basis.
What is ischemic heart disease?
Inadequate blood to myocardium due to obstruction of coronary arteries.
Echocardiography cannot detect past silent infarctions
FALSE
How do antiplatelets reduce risk of thrombotic events?
Preventing platelets from clumping together to form a clot.
A 82 year old male experienced a STEMI 2 years ago. PMH includes hypertension, CAD, diabetes, and HFrEF. He was prescribed metoprolol succinate following his STEMI, does he still need to be on it?
YES - He has heart failure.
Name 5 risk factors of CAD
High LDL, low HDL, HTN, DM, smoking, family hx, obesity, men>45 yo and women>55 yo
Chest discomfort in CCD is predictable and can be relieved with nitroglycerin.
TRUE
What medications and does ranges are considered high intensity statins?
atorvastatin 40-80 mg
rosuvastatin 20-40 mg
A 63 year old female had an NSTEMI with PCI 18 months ago among other comorbidities. Her medications include aspirin, lisinopril, metoprolol succinate, apixaban, and atorvastatin. Is aspirin still indicated for her PCI hx?
NO - she is on a DOAC and has been >12 months
Name 3 events that are classified as an ASCVD event
CHD (MI, angina, coronary artery stenosis)
CVD (Ischemic stroke, TIA, carotid artery stenosis)
CAD
PAD/PVD
E-cigarettes are recommended to increase likeliness of successful smoking cessation
FALSE
What is the beneficial mechanism of action of beta blockers in CCD?
Decreases myocardial oxygen demand
Impedes LV remodeling
A 74 year-old female with PMH of AF, HTN, CAD, and had an NSTEMI 2 months ago that required a PCI. Pertinent medications in losartan, amlodipine, rivaroxaban, clopidogrel, and aspirin. Which medication should she discontinue at this time?
Aspirin - indicated to be on DOAC and clopidogrel for 1-6 months depending on bleeding risk. Then returns to DOAC alone.