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Cardio Exam 2 > Primary and Secondary Prevention of ASCVD, CAD, Cerebrovascular Accidents > Flashcards

Primary and Secondary Prevention of ASCVD, CAD, Cerebrovascular Accidents Flashcards

1
Q

When do you beginning screening for CAD/CVA

A

At age 20 and repeated every 4-6 years in those without established CV or CVD

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2
Q

If age 40-79,

A

use 10 yera Pooled Cohort Risk Equation to estimate short-term ASCVD risk

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3
Q

If age 20-39 or low risk (<7.5%) and age 40-79

A

use 30 yera Framingham score

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4
Q

Primary prevention w/o compelling indication =

A

ACEi/ARB + CCB or Thiazide

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5
Q

Coronary artery disease =

A

BB + ACEi/ARB

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6
Q

Recurrent stroke prevention =

A

Thiazide +/- ACEi

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7
Q

CKD or DM =

A

ACEi/ARB

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8
Q

Glycemic control prevents

A

Progression of microvascular complications (neuropathy, nephropathy, retinipathy)

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9
Q

Lifestyle modifiications

A

Cessation of tobacco and avoid environmental exposure
10% weight loss in 6 months (BMI 18.5-24.9)
30 minutes of moderate intensity activity 3-4 times a week
<1 for women

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10
Q

Cardiac rehabilitation

A

Medically supervised training

Those with a history of CAD esp after MI or Chronic Stable Angina

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11
Q

Define atheroembolic event

A

Plaque rupture has caused a MI or stroke/TIA

Treatment: Antiplatelets

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12
Q

Atheroembolic event treatment

A

Aspirin

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13
Q

Define cardioembolic event

A

Abnormal blood flow, inflamation, or endothelial damage puts you at risk of activation of clotting factors leading to a stroke/TIA
Treatment: Anticoagulants

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14
Q

Cardioembolic event treatment

A

Coumadin

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15
Q

Primary Prevention of Atheroembolic process (CAD) and Atheroembolic stroke/TIA

A

Aspirin 75-162 PO daily IF: high risk of ASCVD and NO peptic ulcer disease

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16
Q

Secondary Prevention of Atheroembolic process (CAD)

A

Silent CAD, Chronic SA, Symptomatic PVD: Aspirin 75-162 mg PO daily or clopidogrel

History of UA/NSTEMI/STEMI: Aspirin + P2Y12 inhibitor for 12 months after initial event (clopidogrel, prasugrel, ticagrelor)

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17
Q

Secondary Prevention of Atheroembolic stroke/TIA

A

Clopidogrel 75 mg QD,
Aggrenox BID OR
Aspirin 5-325 mg QD
- No combos!!

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18
Q

Primary and Secondary Prevention of Cardioembolic stroke/TIA (Afib or valve replacement

A

CHA2DS2Vasc

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19
Q

CHA2DS2Vasc Scoring

A 
CHF: 1
HTN: 1
Age greater than 75: 2
65-74: 1
DM: 1
Stroke/TIA: 2
CAD/MI: 1
Female: 1
20
Q

CHA2DS2Vasc Scoring = treatment

A

0: no antithrombotic therapy
1: aspirin or anticoagulant
>/=2: Anticoagulant

21
Q

Heart valve replacement with mechanical prosthesis treatment

A

Warfarin +/- aspirin

22
Q

Aggrenox Dosing

A

200/25 mg ASA

23
Q

Clopidogrel (Plavix) Dosing

A

75 mg daily

24
Q

Prasegrel (Effient) Dosing

A

5-10 mg daily

Expensive

25
Q

Ticagrelor (Brilinta) Dosing

A

90 mg daily

Expensive

26
Q

Dabigatran (Pradaxa) Dosing

A

75-150mg BID

27
Q

Rivaroxabin (Xarelto) Dosing

A

15-20 mg QD

28
Q

Apixaban (Eliquis) Dosing

A

2.5-5 mg BID

29
Q

ASCVD Risk

A

Green: Sedentary, supoptimal diet, tobacco and EtOH
Yellow: Dyslipidemia
Red: Excessive weight and HTN

30
Q

Silent ASCVD

A

> /= obstruction of coronary artery (green)
Chronic stable angina (yellow)
CAD
PAD (yellow)

31
Q

Hard ASCVD

A

ACS (yellow)

Stroke/TIA (redish)

32
Q

Primary Prevention (Green Zone)

A

Prevent CAD/CSA/MI/Stroke/TIA by controlling BP, dyslipidemia, tobacco, lifestyle factors, and potentially initiating therapy for high-risk pts

33
Q

Secondary Prevention (Red Zone)

A

Prevent CAD/CSA/MI/Stroke/TIA by controlling BP, dyslipidemia, tobacco, lifestyle factors, and initiating antithrombotic therapy for all pts without contraindications

34
Q

CV Risk

A 
HTN (thumb)
Dyslipidemia
DM
Lifestyle
Anti-thrombotics (pinkie)
35
Q

Define CAD

A

Arterial sclerosis leads to plaque rupture
Platelets play a large role in treatment and prevention
Anti-platelet therapy

36
Q

Define Atheroembolic stroke

A

Arterial sclerosis leads to plaque rupture
Platelets pay a large role in treatment and prevention
Anti-platelet therapy

37
Q

Define Cardioembolic Stroke

A

Abnormal blood flow, inflammation or endothelial damage leads to activation of clotting factors
Anticoagulant therapy for Afib

38
Q

MI Therapy

A

Aspirin +/- Plavix, Effient, Brillinta

39
Q

Atheroembolic stroke Therapy

A

Plavix
Aggrenox
Aspirin

40
Q

DVT or PE Treatment

A

Warfarin

Xarelto

41
Q

Cardioembolic Stroke (Afib or Valve disease)

A

Anticoagulants (warfarin, Pradaxa, Xarelto, Eliquis

42
Q

Atheroembolic event =

A

Antiplatelets

43
Q

Thrombo/Cardioembolic Event =

A

Anticoagulants

44
Q

Someone has MI and was previous taking aspirin and now has an increased risk of bleeding, what do you do?

A

Keep the aspirin on bc it would be worse without it

45
Q

Men VS Women

A 
Men = more MI
Women = more Strokes

Cardio Exam 2 (10 decks)

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