A. Pitavastatin (Livalo) 4 mg B. Rosuvastatin (Crestor) 20 mg C. Atorvastatin 20 mg D. Pravastatin 80 mg

A. This agent is appropriate as monotherapy in post-myocardial infarction patients B. The major adverse events associated with vorapaxar include angioedema and Stevens-Johnson Syndrome C. Vorapaxar is a novel P2Y₁₂ inhibitor D. Vorapaxar is contraindicated in patients with a history of stroke or transient ischemic attack

A. Combined use of ACE inhibitors and ARBs is recommended for all patients following an MI B. An ACE-induced cough will likely resolve itself within the first 6 months of presentation C. ACE inhibitors can cause angioedema that can be serious and even life-threatening D. ACE inhibitors and ARBs can cause an acute increase in alanine aminotransferase (ALT) upon initiation and therefore, should not be used by patients with hepatic transaminase levels > 3 times the upper limit of normal.

A. Beta blockers should be continued indefinitely in all patients with prior ST segment elevation myocardial infarction (STEMI) B. Beta-blockers should be continued indefinitely in all patients with prior unstable angina/ non-ST segment elevation myocardial infarction (UA/NSTEMI) C. Beta-blockers should be discontinued in all patients with prior UA/NSTEMI after a period of three years D. Beta-blockers should be discontinued in all patients with prior STEMI after a period of 3 years

A. Routinely drawing low-density lipoprotein cholesterol (LDL-C) levels is still recommended, although LDL-C treatment goals have essentially been abandoned by updated guidelines B. Routine monitoring of liver function tests is recommended C. All patients presenting with muscle symptoms should have a creatine kinase level monitored to rule out rhabdomyolysis D. Triglycerides should be monitored periodically and levels > 300 mg/dL should be treated with nonstatin alternatives

A. Less than 10% of the total annual costs of ACS result from rehospitalization because of secondary complications B. Although a large percentage of patients will die within 5 years after their first MI, the remaining population is at a low risk of further complications C. Medications used for secondary prevention are effective in decreasing the prevalence of complications associated with MI D. Depending on the estimates used, ACS account for less than half a million hospitalizations each year

A. It is the responsibility of all health care providers to assist patients with overcoming barriers associated with obtaining and adhering to medications B. Nonadherence to secondary preventative medications following MI has been shown to lead to poorer outcomes C. Pillboxes, calendars, refill reminders, and synchronization are all useful tools for improving adherence D. Patients should be switched to brand-name medications to help reduce confusion regarding lengthy, difficult to pronounce generic names

A. Higher doses of aspirin, such as 325 mg daily, are associated with better outcomes and an increased bleeding risk compared with lower doses, such as 81 mg daily B. The highest dose of aspirin that can be safely used with clopidogrel is 81 mg daily C. Patients with gout should completely avoid aspirin because of aspirin's ability to increase urate excretion and increase serum uric acid concentrations D. The bleeding risk of triple antithrombotic therapy with aspirin, a P2Y₁₂ inhibitor, and a vitamin K antagonist is 3 to 4 times greater than the bleeding risk of aspirin alone

A. For patients with STEMI, beta-blockers should be withheld in the acute setting and started within 7 days B. Certain beta-blockers have specific beneficial effects for other disease states and therapy should be tailored to patients' specific needs C. Beta-blockers definitively improve outcomes in patients treated with percutaneous coronary intervention (PCI) D. Reduced mortality is a class effect in patients with heart failure with left ventricular systolic dysfunction

A. The first step in establishing a causal relationship between statin therapy and mild-to-moderate muscle symptoms is to slowly titrate the dose of the statin down B. For mild-to-moderate muscle symptoms, the statin should be discontinued promptly and the patient evaluated for the possibility of rhabdomyolysis C. If mild-to-moderate muscle pain resolves upon initial discontinuation of a statin, the patient should be switched to a nonstatin alternative D. Creatine kinase levels greater than 10 times the upper limit of normal and an increase in serum creatinine are indicative of rhabdomyolysis