Secondary prevention of CAD

Question 1

antiplatelet therapy after coronary stenting

Answer 1

DAPT for minimum of 6-12 months after BMS or DES placement
DAPT minimum of 4 weeks in select pts after BMS
Continue DAPT in total of 30 months if posible (low bleeding risk)
continue ASA indefinitely

Question 2

IF planning to do surgery, what are the recommendations for DAPT?

Answer 2

Elective surgery: defer surgery until minimum DAPT duration
Urgent surgery: continue P2Y12 receptor blocker or HOLD For shortest duration possible
Continue aspirin unless high risk of severe surgical bleeding.

Question 3

POST MI intervention that improves outcomes after MI with improvement in functional status and quality of life and reduction in repeat hospitalization, recurrent MI and all cause mortality

Answer 3

cardiac rehab - all pts with recent MI, CABG, stable angina pectoris, PCI should get this.

Question 4

after MI and EF<40% need to be started on this?

Answer 4

ACE i, beta blocker

Question 5

what exercise interventions can be done to reduce cardiac risk?

Answer 5

exercise of any kind reduces risk. Typical recommendations include:

150 min/ week moderate aerobic exercise or 75 minutes of vigorous exercise

strength training 2 times/ week

Question 6

what diet should patients adopt to lower cardiac risk?

Answer 6

Mediterranean diet
increased fruit, vegetables, whole grains, legumes, nuts, olive oil, poultry and fish

decrease intake of red meat, salt, saturated fats, moderate intake of red wine (optional)

Question 7

what is the DASH diet?

Answer 7

helps to lower cardiac risk

intake: fruits, vegetables, whole grains, low fat diary and nuts and fish and poultry

decrease intake of red meat, fats, sweets,

Sodium <2.3 g/day or <1.5 lower sodium DASH diet (meant for out of control HTN pts)

Question 8

what other habits can help decrease cardiac risk?

Answer 8

stop smoking and moderate and alcohol intake?

Question 9

what is associated with heavy intake of alcohol ?

> 4 drinks per day per man or 2 drinks per day for women?

Answer 9

increased risk for heart failure.

Question 10

in a diabetic pt with stable angina and CAD and HTN what medication could be added to help lower her risk for future MI or cardiovascular events?

Answer 10

SGLT-2 inhibitor