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Post-NSTEMI Management — RACP Adult Medicine MCQ

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ModerateCardiologyPost-NSTEMI ManagementRACP Adult Medicine

A 63-year-old man had NSTEMI treated with PCI 3 months ago. LVEF is 55%. He is on aspirin, ticagrelor, atorvastatin 80 mg, and perindopril. His LDL is 2.1 mmol/L. Which additional therapy is most appropriate?

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Correct answer: D — Aspirin + ticagrelor + statin + ACEi + beta-blocker

With preserved LVEF post-ACS, the standard regimen includes DAPT, high-intensity statin, ACEi, and beta-blocker. MRA is not indicated without LVEF ≤40% with HF. His LDL remains above the target of <1.8 mmol/L on maximal statin; ezetimibe or PCSK9 inhibitor should be considered. A beta-blocker should be added to this regimen.

Reference: NHFA/CSANZ – 2025 – ACS Secondary Prevention Guidelines