Medicine>>>>>General Medicine and Prevention
Question 4#

A 60-year-old man had an anterior myocardial infarction 3 months ago. He currently is asymptomatic and has normal vital signs and a normal physical examination. His echocardiogram shows a mildly depressed ejection fraction of 40%. He is on an antiplatelet agent and an ACE inhibitor. What other category of medication would typically be prescribed for secondary prevention of myocardial infarction? 

a. Alpha-blocker
b. Beta-blocker
c. Calcium-channel blocker
d. Nitrates
e. Naproxen sodium

Correct Answer is B

Comment:

Beta-blockers are documented to lower the risk of myocardial reinfarction, whereas some calcium channel blockers may increase the risk. Alpha-blockers have been associated with an increased risk of congestive heart failure. ACE inhibitors are beneficial in this setting and should be continued. Despite their decades-long use for the symptomatic treatment of angina, nitrates are not indicated for secondary prevention of infarction. Recently, long-term use of some nonsteroidal anti-inflammatory drugs (including naproxen sodium) has been associated with an increased risk of myocardial infarction.