Illness Prevention, Health Promotion, and Integrated Care — Primary and secondary prevention for cardiovascular disorders

A 60-year-old woman is being discharged on day 4 after an anterior ST-elevation myocardial infarction treated with primary PCI and a drug-eluting stent to the left anterior descending artery. She has type 2 diabetes managed with metformin and has no history of bleeding, asthma or heart block. She has been free of chest pain and dyspnea at rest since the procedure and has no signs of heart failure on examination. Echocardiography shows a left ventricular ejection fraction of 38%. Creatinine 76 µmol/L (45-90), eGFR 84 mL/min/1.73 m², potassium 4.2 mmol/L (3.5-5.0), LDL-C 4.1 mmol/L, HbA1c 7.4%. Aspirin, ticagrelor and atorvastatin 80 mg daily were started in hospital and metformin was continued.