Flashcards in 41 - Post-MI Deck (23):
DAPT x how long?
-target waist circumference < 100 cm in males and < 90 cm in females
-sustain 5-10% weight loss
-ICD is indicated in select patients with significant residual LV dysfunction despite aggressive medical therapies for 3 or more months
After MI, what are patients at risk for?
MACE (major adverse CV events)
Secondary prevention with several classes of drugs independently reduces incidence of MACE by ___%
current guidelines say to use what?
prasugrel or ticagrelor as 1st line after NSTEMI or STEMI but they have increased bleeding rates compared to clopidogrel
Ticagrelor can cause ______
Antiplatelet therapy consists of ?
ASA + P2Y12 inhibitor
When should beta blockers be started ?
within a few days of infarction
BB should be continued indefinitely but can be stopped in what situations?
if patients have normal LV function or if fatigue or other s/e are affecting QOL
ACEi considered for all patients post-MI especially if they have what other medical conditions?
LVEF < 40%, HTN or DM
How do ACEi's help post-MI?
play a role in LV remodelling post-MI
they decrease CV death and MI
Who should ACEi be avoided in?
pregnant patients, renal dysfunction or hyperkalemia
____ as alternative to ACEi
Consider MRA (ex. spironolactone, eplerenone) in which patients?
those with significant LV dysfunction
Use ___-dose statins early after MI
What is your target for statins?
LDL < 2 mmol/L or 50% decrease from baseline
Which alternative cholesterol lowering agents can be used?
-ezetimibe - also helps with CV risk
Use oral anticoagulants for which patients?
post-MI with a. fib
Warfarin + DAPT increases bleed risk so which P2Y12 inhibitor should you use?
clopidogrel bc it has least risk of bleed compared to others in it's class
If thrombus dissolved in 3 months, what do you do?
consider d/c anticoagulant
What other anticoagulants may have less bleed risk compared to warfarin?
Avoid which diabetic medication post-MI