CVD PREVENTATION MEDS

Question 1

What is the lifetime estimated risk for atherosclerotic cardiovascular disease (ASCVD) in diabetic patients?

Answer 1

Approximately 40%

This estimate is derived from the ASCVD Risk Estimator.

Question 2

What is the recommended treatment for lowering LDL cholesterol in diabetic patients?

Answer 2

Switch to a high-potency statin to lower LDL cholesterol by >50%

High-potency statins include rosuvastatin and atorvastatin.

Question 3

List two high-potency statins recommended for diabetic patients.

Answer 3

• Rosuvastatin
• Atorvastatin

Simvastatin is not recommended.

Question 4

According to guidelines, when should a high-potency statin be prescribed?

Answer 4

For:
* Clinical atherosclerotic cardiovascular disease
* LDL-cholesterol >190 mg/dL
* 10-year risk >7.5%

These criteria help identify patients at higher risk.

Question 5

What was the primary efficacy outcome of the aspirin trial conducted on diabetics?

Answer 5

First serious vascular event

Examples include myocardial infarction and stroke.

Question 6

What was the primary safety outcome of the aspirin trial?

Answer 6

First major bleeding event

An example is intracranial hemorrhage.

Question 7

What were the results of the aspirin trial regarding serious vascular events?

Answer 7

Lower in aspirin group (8.5%) vs. placebo (9.6%); rate ratio 0.88 (95% CI 0.79-0.97; P = .01)

This indicates a statistically significant reduction in serious vascular events with aspirin.

Question 8

What were the results of the aspirin trial regarding major bleeding events?

Answer 8

Higher in aspirin group (4.1%) vs. placebo (3.2%)

Most bleeding events were gastrointestinal.

Question 9

What was concluded from the aspirin trial regarding its use in high-risk diabetics?

Answer 9

Aspirin prevents serious vascular events but increases major bleeding risk

Benefits are counterbalanced by the bleeding hazard.

Question 10

What is the recommended dosage of aspirin for primary prevention in high-risk diabetics?

Answer 10

75-162 mg daily

This recommendation is for diabetics with optimized risk factors.

Question 11

What effect do lixisenatide and sitagliptin have on major adverse cardiovascular events?

Answer 11

No significant reduction

These medications did not show a benefit in preventing cardiovascular events.

Question 12

What is the effect of empagliflozin on major adverse cardiovascular events?

Answer 12

Reduced events but mainly in secondary prevention

The primary prevention benefit is not clear.

Question 13

What is the primary benefit of SGLT-2 inhibitors?

Answer 13

Benefit primarily in heart failure-related events

These medications have shown effectiveness in managing heart failure.

Question 14

PIC

Answer 14