Prevention of Cardiac Disease

Question 1

What medications for prevention of cardiac disease e.g. those with Angina?

Answer 1

Aspirin 75mg OD, Statin, ACEi +/- anti-hypertensives

Question 2

ABCDE of secondary prevention following ACS

Answer 2

A- ACEi or ARB
B - Beta Blocker
C - Cardiac rehab
D - Dual Anti-platelet therapy
E - Ejection fraction reduced? Start Aldosterone Antagonist

Question 3

Dual anti-platelet therapy following ACS? (Not anti-coagulant)

Answer 3

Aspirin + Clopidogrel/Ticegralor/Prasugrel

Question 4

anti-platelet following ACS if using an anticoagulant

Answer 4

If PCI- Clopidogrel
If no PCI or high bleeding risk- Aspirin

Question 5

Who should we consider primary prevention statin use in? (20mg)

Answer 5

Those <85 years QRISK score of >10

T1DM >40 years or dm for >10 years
+ PVD or risk factors CVD

PVD, familial hypercholesterolemia

Question 6

Who should we start secondary prevention statins in? (80mg)

Answer 6

Those with CVD, angina, TIA, Stroke, PVD

Question 7

When are statins contraindicated

Answer 7

Pregnancy and breast feeding (should be stopped 3 months prior to conceiving)

Liver disease/ increased

Question 8

Who should we be cautious with when it comes to statins?

Answer 8

Previous haemorrhage stroke
Risk of rhabdomyolysis

Question 9

What tests should be done prior to starting statin?

Answer 9

Non fasting lipids
TFTs in those with thyroid disease
LFTs
UEC
HBA1c
CK