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Stable CAD Secondary Prevention — RACP Adult Medicine MCQ

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EasyCardiologyStable CAD Secondary PreventionRACP Adult Medicine

A 65-year-old man with known stable coronary artery disease (prior PCI 3 years ago, now on aspirin only) presents for routine review. He has no symptoms (CCS class I). Echo shows LVEF 55%. Stress echo shows no inducible ischaemia. LDL-C is 1.2 mmol/L on atorvastatin 80 mg. BP is 125/75. HbA1c is 51 mmol/mol. He is on aspirin, atorvastatin, and perindopril. What is the most appropriate ongoing management?

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Correct answer: D — Continue current medications — optimal secondary prevention

Asymptomatic patient with stable CAD 3 years post-PCI, no inducible ischaemia, LVEF preserved, and LDL-C below target (<1.4 mmol/L) on optimal secondary prevention (aspirin, high-intensity statin, ACEi) represents well-managed stable CAD. Continue current therapy. Colchicine 0.5 mg daily (LoDoCo2/COLCOT trials: reduced MACE in stable CAD by ~30%) could be considered as an add-on for residual inflammatory risk, but is not yet universally recommended in Australian guidelines.

Reference: CSANZ – 2025 – CCS; ESC 2024 CCS; LoDoCo2/COLCOT