Acute Coronary Syndrome

Question 1

What outpatient medications can/should (depending on contraindications) be prescribed after an MI?

Answer 1

ASA, P2y12 inhibitor (clopidogrel/Plavix), Beta Blocker, NTG, Statin, ACE Inhibitor

Question 2

For a patient receiving a cardiac stent, how long should a P2y12 Inhibitor (anti platelet) medication be prescribed?

Answer 2

Drug Eluding Stent: ≥12 months

Bare Metal Stent: up to 12 months

Question 3

If a patient did not receive PCI or angiography after their MI, what is the recommended anti platelet treatment (with P2y12 Inhibitor) for outpatient care?

Answer 3

Clopidogrel (Plavix) 75mg up to 12 months

If bleed risk exists, may discontinue sooner.

Question 4

How long after and MI should a patient be prescribed a Beta Blocker (if no contraindications and the BP can support it)?

Answer 4

At least 6 months, but ideally 3 years

If the patient has a low Ejection Fraction - should be prescribed indefinitely.

Question 5

After an MI, what kind of patient should be prescribed a statin?

Answer 5

All of them. Dose should be doubled if patient was already on a statin.

Question 6

Upon discharge from the hospital after and MI, what kind of patient should be prescribed an ACE Inhibitor?

Answer 6

Patients with a BP that can support it
Patients with an EF of ≤ 40%
Patients with DM or CKD