Long-Term Cardiac Care: Medications and Treatments

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Long-Term Cardiac Care: Medications and Treatments

Cardiac care is of much concern to doctors and patients need to work towards a healthy heart. Cardiac treatment is sophisticated and medications are there to protect the heart from further damage.

If a person has suffered from a heart attack then he or she is prescribed medication life-long. Cardiac care is very important to maintain good health.

There are several types as well as combinations of drugs that are made use of to treat coronary artery disease (CAD), and the doctor or other health care provider will then decide the best treatment combination for one’s situation. Cardiac treatment entails a lot of medications and it is worth knowing a few of them.

Medications made use are :

  • Anticoagulants
  • Antiplatelet Agents and Dual Antiplatelet Therapy
  • ACE Inhibitors
  • Angiotensin II Receptor Blockers
  • Angiotensin Receptor-Neprilysin Inhibitors
  • Beta Blockers
  • Diuretics
  • Calcium Channel Blockers
  • Cholesterol-lowering medications
  • Digitalis Preparations
  • Vasodilators

Commonly prescribed include:

  • Apixaban (Eliquis) 
  • Dabigatran (Pradaxa)

Reason for Medication

  • Helps prevent clotting in patients who have suffered from a heart attack, unstable angina, ischemic strokes, TIA (transient ischemic attacks), and other forms of cardiovascular disease.
  • Can also be given as preventive medication when plaque buildup is evident but yet there is not a major blockage in the artery.

Long-Term Cardiac Care: Medications and Treatments

  • Certain patients will be prescribed aspirin which is of course combined with another antiplatelet drug – also called dual antiplatelet therapy (DAPT). 

Dual Antiplatelet Therapy (DAPT)

Few patients who have suffered heart attacks, have stents placed in their coronary arteries, or tend to undergo coronary artery bypass graft surgery (CABG) are rather treated with two types of antiplatelet agents at the same time to prevent blood clotting. This is known as dual anti-platelet therapy (DAPT).

One antiplatelet agent happens to be aspirin. Almost everyone with coronary artery disease, even those who have had a heart attack, stent, or CABG are treated with aspirin for the rest of their lives. A second type of anti-platelet agent, referred to as a P2Y12 inhibitor, is usually prescribed for months or years in addition to aspirin therapy.

The type of medication and the duration of one’s treatment will vary based on the condition and other risk factors. The risks and benefits of DAPT need to be sorted out with the healthcare provider.

  • If not had a heart attack, but have atherosclerosis in one’s coronary arteries and had a stent placed, in addition to aspirin, then the person needs to be on clopidogrel for at least 1-6 months, depending on the type of stent which was placed, risk of clotting the stent, and bleeding risk.
  • If had a heart attack and a coronary artery stent placed, or if the patient is being treated with medical therapy (no stent, clot buster, or surgery), in addition to aspirin, he or she needs to also be on a P2Y12 inhibitor for about 6-12 months. In a few cases, it may be advisable to be on DAPT longer. This needs to be addressed by the healthcare provider. The three P2Y12 inhibitors currently available that perhaps may be prescribed are clopidogrel, prasugrel, and ticagrelor.

Clopidogrel does decrease the risk of stroke and MI but does not change the risk of death for specific patients. The choice of what type of medication, the cost of the medication, and the duration of treatment will be decided after discussions are held with the health care provider.

Few patients who undergo coronary artery bypass surgery may be treated with a P2Y12 inhibitor for a year after the bypass operation. Once this is over, the P2Y12 inhibitor might be stopped, but aspirin is usually continued long-term. The surgeon will discuss if this treatment is needed.

These are general recommendations for the duration and type of dual anti-platelet therapy which could be used after coronary artery stenting, heart attack, and CABG. Again, it is important to talk to your healthcare provider about your treatment plan.

Conclusion

Cardiac care is of utmost importance. 

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