Figure 411

a. severe left circumflex artery stenosis b. severe left main trunk stenosis c. severe left anterior descending artery steivd-

d. severe right coronary artery stenosis

73. I he use of combination evidi nce-based therapies (antiplatelet agents, statins, beta-blockers, angiotensin convert ng enzyme inhil i'.ors) in patients with acute coronatv syndrome is associated with a. significant reduction in recurrent angina 1". t in irtalit) benefit b. significant survival ;ihantage C. no significant elinii al benefits

74. The Clinical Outcomes Uti izing Revascularization ir Aggressive Drug Fvalua tion (COURAGE) trial was designed to determine whether PCI coupled with optimal medical therapy reduces the risk of death and nonfatal myocardial infarction in patients with stable coronary artery disease, as compared with opti trial medical therapv alone, and demonstrated that a. PCI reduced the risk of death, myocardial infarction, or other major cardio-vasu lar events wlic" added to.opt trial incdical therapy f b. ' k i ■ ' •ciliKi ill« ! I i.' ih -ill ni\o, aioial mi,Hi. hi ili i ,11

v.UiinAasi.li,. t cvitU when ikied l<i i)|>linial m<■■ li, a u C. !'< did not n diue the 11-i t> ..U ill nnov.aidi.tlmf." h j • >,,

■ i! mgin.i i i ilhi i nii<i\ . tl.ii 'Miit'. whi"' ui>. • " n • n.a ni'-'iu a' ilu'i, py

75. The angiogram l-ig •! i m ;h <■' '.mi .>Ui n,.„i . ' •> • >-u-t >r ischemia reveals

FIGURE 4-12 ?

a. severe left circumflex artery stenosis b. severe left main trunk stenosis c. severe left interior descending artery stenosis d- severe right coronary artery stenosis \

76. In the initial randomized trials of drug-eluting stents '! 'I.S dual antiplatelet therapy with aspirin and clopidogrel was recommended lor a. I month for sirolimus-ehiting and paclitaxel eluting stents b. . months for sirolimus-eluiing arrd paclitaxel eluting stents

C. J to 3 months for sirolimus-eluiing and << months fo paclitaxel clutin ■ stents d. months I >i siroliinus eluting and paclitaxel-ehT'ig stents e. i. months tot sirolin us-eluting and paclitaxel e'ulinv r.n1 ,

77. Your patient presented in an outside hospital with an acute coronary syndrome and mderwent a dnig-eluting stent (1 )|.Si based pe? u'aneous iionarv ter vc.'.tion ll'(ll). I nlortun.ilely, the patient has an ahsol u m feat on loi ma! anticoagulation because ol a prosthetic mitral \.il>- V->:ii hes' a 'o >n r dns moment s a. '\.l;niiiislei dual jniip!.:1 v! the-.:;" ! " * >»>• •>!>••» .•• ,ut,;i!,i n . ial anticoagulation, ami then continue \Mth .ispin: ,. 'd '"il ant • v.g- I-i i lefmite.y.

b. V.minisier dual antiplatelet therap\ loi I moi addition '." coagulation, and then -.ontinue with aspirin an' oiai ante <:g l.ition di' ••;: l\.

c. Administer dual autiplateiet therapy to; at ¡east 6 months, i! possible !..' months, i',-. addition to on^jmti apilatim m«' theiiflpr.m.K- with .tspirip im ntn oagubtion indelin tel\

d. Since the patient is anliioagulated. the combination with aspir in long teim is .¿jfticitn!

e. Since the patient is anticoagulated, the combination with clopidogrel long term is sulticienl.

78. The angiogram fFig. ■1--13 i" ml 54-yenr-old ma": with acute lateral w li niyafardffl i.nf-u. nrm reveals

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