secondary prevention after cardiovascular events

Question 1

lipid modifying drugs

Answer 1

should be given irrespective of the patient’s lipid levels
use high intensity statin therapy

Question 2

antiplatelet and anticoagulant drugs

Answer 2

following ACS, aspirin and a P2Y12 inhibitor eg. clopidogrel, prasugrel or ticagraor is recommended for 12 months

Question 3

ACEI

Answer 3

aim to titrate to the maximum daily dose if tolerated

Question 4

beta blockers

Answer 4

12 month corse of beta blocker therapy
patients with angina may benefit from long term therapy
avoid in patients with chronic limb threatening ischaemia unless the benefits outweigh the harm

Question 5

colchicine

Answer 5

colchicine reduces the incidence of MI, stroke and urgent revscularisation
consider the addition of colchicne under the guidance of a specialist

Question 6

summary of the drug therapy for secondary prevention of artherosclerotic crdiovascular disease

Answer 6

high intensity statin
antiplatelet drug (sometimes with low intensity anticoagulant therapy)
ACEI
+ plus in selected patients, you may add a beta blocker, antihyperglycaemic drugs and colchicine