What Medication Would You Recommend for a 66-Year-Old Male Who Underwent PCI After MI? | Patient Case Quiz

A 66-year-old gentleman comes for a follow-up clinic visit. He had suffered a myocardial infarction (MI) and underwent primary coronary intervention (PCI) two years ago. He completed cardiac rehabilitation and is currently asymptomatic. His other past medical history includes hypertension and hyperlipidemia. His current medications include aspirin 81 mg daily, metoprolol tartate 12.5 mg twice a day, lisinopril 20 mg daily, and atorvastatin 80 mg daily. His vitals today are as follows: heart rate 80 bpm, blood pressure (BP) 136/88 mm Hg, respiratory rate 16 per min., and oxygen saturation of 96% on room air. His physical exam is otherwise unremarkable. His electrocardiogram (ECG) shows normal sinus rhythm with Q waves in inferior leads. Transthoracic echocardiogram six months ago showed normal regional and global systolic function. Laboratory data are unremarkable, with normal hemoglobin, potassium and creatinine.

Which of the following medication changes would you recommend in this clinic visit?

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