Chapter 23 – ACS & Post MI (QE) Sample Questions
1. MJ is a 49-year-old woman who presented at the hospital emergency with symptoms of severe chest pain, sweating, nausea and vomiting. ECG and serum cardiac biomarkers including creatine kinase- MB and troponin I tests were immediately performed. The results confirmed diagnosis of ST elevated myocardial infarction suggesting blockade in the right artery. Within 90 minutes from arrival at the hospital emergency, percutaneous infusion (PCI) was done and metal stent was placed within the right artery to restore blood flow at the infarcted site. Patients like MJ with the acute coronary syndrome who had STEMI are at high risk of the recurrent event as well as development of a secondary complication. Antiplatelet therapy is critical for preventing recurrent thrombosis and is of particular importance to patients who received stent. Which of the following dual antiplatelet therapy should be continued for a minimum of 12 months?*
- A. Acetylsalicylic Acid
- B. ASA/Dipyridamole
- C. ASA/Clopidogrel
- D. ASA/Ticagrelor
Ans:
D
Tips: Ticagrelor is recommended as first-line therapy in patients with ACS. Wallentin L, Becker RC, Budaj A et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009;361(11):1045-57.
The use of Ticagrelor should be considered in those patients with ACS undergoing stent implantation that is at higher risk for stent thrombosis (previous stent thrombosis, STEMI, history of diabetes mellitus).
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