Cardiology — EECC MCQ

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HardE). Routine stress testing irrespective of impact is not recommended (D)."CardiologyEECC

After lower-limb endovascular revascularisation for symptomatic peripheral arterial disease, a patient has low bleeding risk and no indication for full-dose anticoagulation. Which long-term antithrombotic strategy may reduce limb and cardiovascular events?

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Correct answer: C — Vascular-dose rivaroxaban combined with low-dose aspirin

The best answer is “Vascular-dose rivaroxaban combined with low-dose aspirin”. Dual-pathway inhibition with vascular-dose rivaroxaban and aspirin reduces major adverse limb and cardiovascular events in appropriately selected low-bleeding-risk PAD patients. “Full-dose rivaroxaban plus aspirin and clopidogrel” is less appropriate because full-dose anticoagulation plus DAPT creates excessive bleeding without this indication “Warfarin plus aspirin after endovascular revascularisation” is less appropriate because warfarin is not routine after PAD revascularisation without another indication “Clopidogrel monotherapy after endovascular revascularisation” is less appropriate because revascularisation does not remove systemic atherothrombotic risk “Aspirin plus clopidogrel for indefinite treatment” is less appropriate because triple antiplatelet therapy lacks a favourable long-term risk–benefit balance

Reference: 2024 ESC Guidelines for peripheral arterial and aortic diseases. https://academic.oup.com/eurheartj/article/45/36/3538/7738955