Anticoagulant Use in Diabetic Patients With Stable CAD
A 62-year-old Caucasian male patient presents to your office for routine follow-up. His medical history is significant for hypertension, diabetes mellitus, and coronary artery disease. He had an inferior wall myocardial infarction 4 years ago that was treated with a drug-eluting stent. His last echocardiogram, done 1 year ago, showed normal left ventricular ejection fraction. He currently takes aspirin 81 mg daily, rosuvastatin 20 mg daily, losartan 50 mg daily, and metformin 1,000 mg twice daily.
During today's visit, he reports feeling well without any anginal symptoms. His heart rate is 76 bpm, and his blood pressure is 128/72 mmHg. The remainder of the physical examination is normal. He inquires if he would benefit from the addition of anticoagulant drugs to his medical regimen. The electrocardiogram shows normal sinus rhythm with inferior Q-waves. He denies a history of bleeding or gastrointestinal ulcerations.
Which of the following is the best recommendation regarding anticoagulant use for this patient based on available data?