Post MI treatment

Cardiology

A patient makes a good recovery following emergency treatment. She is a non smoker. Her cholesterol is 3.1 (<5.5) with an HDL of 1.

Assuming she has no contraindications to any of the following which class of drugs should she take following her STEMI? (please select all that apply)

  • ACE inhibitor
  • Statin
  • Calcium Channel Blocker
  • Aspirin
  • Fibrate
  • Thiazide diuretic
  • Loop Diuretic
  • Spirinolactone
  • Clopidrogel
  • Beta Blocker
  • Nitrate

ACE inhibitor
Statin
Aspirin
Beta Blocker

4 key drugs. There is also now new evidence to support the use of Omega3 fatty acids.

Ca channel blocker: no good evidence.

Beta blocker: yes! Not for hypertension as a sole treatment based on the recent evidence from large antihypertension trial data.

Clopidrogel is given for varuing durations following non-ST elevation Myocardial infaction but not in non ST elevation MI (NSTEMI).

Statins should be given to all as secondary prevention as they have a protective effect that goes beyond that of simple lipid lowering.