Approach to drug therapy for secondary prevention of atherosclerotic cardiovascular events

Drug therapy for the secondary prevention of atherosclerotic cardiovascular disease (ASCVD) usually consists of a combination of a statin, an antiplatelet drug (sometimes with low-intensity anticoagulant therapy) and an #[angiotensin converting enzyme inhibitor (ACEI). Beta blockers, antihyperglycaemic drugs and colchicine are appropriate in selected patients.

Combination drug therapy reduces cardiovascular morbidity and mortality, so must be started when ASCVD is diagnosed and continued long term. Some patients with ASCVD may have stopped taking or never received drug therapy for secondary prevention; start drug therapy for these patients.

Encourage and facilitate long-term adherence to therapy by educating the patient on the benefits of combination drug therapy.

All patients with ASCVD should receive annual influenza vaccination, which is associated with a significant reduction in the risk of cardiovascular events. Ensure patients are also up to date with pneumococcal and other vaccinations. For details, see the Australian Immunisation Handbook.