Eab Goals of Therapy Prevent first infarct 00 Prevent second infarct 0o. Limit damage from infarcts KENTUCKY College of Pharmacy
Goals of Therapy • Prevent first infarct • Prevent second infarct • Limit damage from infarcts
Eab Preventing First Infarct Reduction of risk factors g:· Patient education 00 8. LoW-dose aspirin not used for men Increases risk of hemorrhagic stroke 8家:。 Low-dose aspirin may be used for high-risk women 0 KENTUCKY College of Pharmacy
Preventing First Infarct • Reduction of risk factors • Patient education • Low-dose aspirin not used for men – Increases risk of hemorrhagic stroke • Low-dose aspirin may be used for high-risk women
Eab Preventing First Infarct: Atrial Fibrillation 70% not treated appropriately Warfarin 00 Aspirin clopidogrel 当- Dabigatran KENTUCKY College of Pharmacy
Preventing First Infarct: Atrial Fibrillation – 70% not treated appropriately – Warfarin – Aspirin + clopidogrel – Dabigatran
Eab CHADS Score Congestive heart failure, hypertension, age oi :>75 years, diabetes mellitus, and prior stroke 00 or transient ischemic attack stratification scheme o i, Assign 1 point each for CHE, HTN, age275 years, or diabetes 2. Assign 2 points for previous stroke or TIA KENTUCKY ∴ Chest2012;141:e601-365 College of Pharmacy
CHADS2 Score • Congestive heart failure, hypertension, age >75 years, diabetes mellitus, and prior stroke or transient ischemic attack stratification scheme • Assign 1 point each for CHF, HTN, age ≥ 75 years, or diabetes • Assign 2 points for previous stroke or TIA Chest 2012; 141: e601S-36S
Eab CHADS Score 。· f tota=0, give no therapy or aspirin75-325 oMg/day, based on patient preference If total 1, give oral anticoagulant. For patients unsuitable for oral anticoagulation or who choose not to have oral anticoagulation 02(for reasons other than concerns about major bleeding), give aspirin clopidogrel aspirin 75-325 mg/day KENTUCKY Chest2012;141:e6015-36S College of Pharmacy
CHADS2 Score • If total=0, give no therapy or aspirin 75-325 mg/day, based on patient preference • If total ≥ 1, give oral anticoagulant. For patients unsuitable for oral anticoagulation or who choose not to have oral anticoagulation (for reasons other than concerns about major bleeding), give aspirin + clopidogrel > aspirin 75-325 mg/day Chest 2012; 141: e601S-36S