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Question: a 65yearold female with stable ischemic heart disease presented for...

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A 65-year-old female with stable ischemic heart disease presented for a routine primary care visit. Two years earlier the patient underwent a cardiac catheterization procedure to diagnose recurring symptoms of angina, anxiety, and panic. Detecting a blockage in the patient's right coronary artery, her cardiologist inserted a drug-eluting stent during the procedure. The patient's recent history indicated normal measures of renal function and left ventricular systolic function (ejection fraction: 60%), no hypertension or diabetes, and well-managed cholesterol levels (LDL-cholesterol: 65 mg/dL). Her current medications include atorvastatin (80 mg per day) and aspirin (162 mg per day). The patient's 72-year-old husband recently survived a severe myocardial infarction, which caused heart failure and significant disability. His current medications include lisinopril, an angiotensin-converting enzyme (ACE) inhibitor. Concerned about her risks for heart attack, the patient asked the office's physician assistant whether she might benefit from any other medicines, in addition to her prescribed statin and aspirin. What do you advise her?

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