41 - Post-MI Flashcards Preview

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Flashcards in 41 - Post-MI Deck (23):
1

DAPT x how long?

1 year

2

Non-pharms

-weight management
-target waist circumference < 100 cm in males and < 90 cm in females
-sustain 5-10% weight loss
-regular exercise
-ICD is indicated in select patients with significant residual LV dysfunction despite aggressive medical therapies for 3 or more months

3

After MI, what are patients at risk for?

MACE (major adverse CV events)
-nonfatal MI
-death
-stroke

4

Secondary prevention with several classes of drugs independently reduces incidence of MACE by ___%

25

5

Antiplatelet therapy:
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

6

Ticagrelor can cause ______

dyspnea (14%)

7

Antiplatelet therapy consists of ?

ASA + P2Y12 inhibitor

8

When should beta blockers be started ?

within a few days of infarction

9

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

10

ACEi considered for all patients post-MI especially if they have what other medical conditions?

LVEF < 40%, HTN or DM

11

How do ACEi's help post-MI?

play a role in LV remodelling post-MI

they decrease CV death and MI

12

Who should ACEi be avoided in?

pregnant patients, renal dysfunction or hyperkalemia

13

____ as alternative to ACEi

ARB

14

Consider MRA (ex. spironolactone, eplerenone) in which patients?

those with significant LV dysfunction

15

Use ___-dose statins early after MI

high

16

What is your target for statins?

LDL < 2 mmol/L or 50% decrease from baseline

17

Which alternative cholesterol lowering agents can be used?

-ezetimibe - also helps with CV risk
-niacin

18

Use oral anticoagulants for which patients?

post-MI with a. fib

19

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

20

If thrombus dissolved in 3 months, what do you do?

consider d/c anticoagulant

21

What other anticoagulants may have less bleed risk compared to warfarin?

-dabigatran
-rivaroxaban

22

Avoid which diabetic medication post-MI

TZDs

23

Which NSAID is the safest for CV risk?

naproxen

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