Medications for Coronary Artery Disease
Coronary artery disease is a serious condition that can lead to a heart attack or stroke. In addition to helping you make lifestyle changes to help reduce your risk of heart attack and stroke, the experts at Brookhaven Heart encourage you to learn about the cardiac medications available for your particular condition.
When blood platelets stick to one another, they can cause serious problems in your blood vessels and arteries. Antiplatelet agents help keep platelets from sticking together, which can reduce your risk of a future heart attack, and if you have a stent, antiplatelet agents can prevent dangerous clots.
Many doctors prescribe low-dose aspirin as an antiplatelet agent for people who have or are at high risk for coronary artery disease. Low-dose aspirin can be taken on its own to reduce the risk of clots, or as part of a regimen that includes other antiplatelet agents following stent placement. Side effects include a risk of stomach ulcers or bleeding, so be sure to let your doctor know right away if you notice bloody or dark stools after you start taking low-dose aspirin.
Plavix is a common antiplatelet agent often prescribed following placement of a stent. Many patients take both Plavix and low-dose aspirin for at least 12 months after receiving a medicated stent. Work with your cardiologist to determine how long you should continue taking Plavix and any other medication.
Brilinta is a newer antiplatelet agent that has been shown to reduce the risk of recurring heart attacks. If you experience shortness of breath or breathlessness while taking Brilinta, talk to your cardiologist right away.
Many cardiologists use Effient for situations that require a more powerful drug than Plavix. While stronger and more effective than other antiplatelet agents, Effient also carries added risk for bleeding. Talk to a cardiologist before you take Effient or any other medication.
Many patients who have coronary artery disease, high blood pressure, atrial fibrillation or congestive heart failure take beta blockers to ease the heart’s workload by reducing heart rate and blood pressure. Common beta blockers include:
- Acebutolol (Sectral)
- Atenolol (Tenormin)
- Bisoprolol (Zebeta)
- Metoprolol (Lopressor, Toprol XL)
- Nadolol (Corgard)
- Carvedilol (Coreg)
- Nebivolol (Bystolic)
- Betapace (Sotalol)
- Propranolol (Inderal)
Anticoagulants are designed to reduce the risk of stroke and prevent blood clots in patients with atrial fibrillation. Commonly used anticoagulants include:
- Coumadin (Warfarin) is effective at reducing stroke risk, but can lead to bleeding and can interact with other drugs or foods. Patients taking Coumadin should be monitored with regular blood tests.
- Pradaxa (Dabigatran), Xarelto (Rivaroxaban) and Eliquis (Apixaban) all help reduce risk of stroke and do not require regular monitoring with blood tests, but might not be good options for patients with artificial heart valves.
Congestive Heart Failure
In patients with congestive heart failure, beta blockers help reduce blood pressure, relieve some of the heart’s workload, and can lower the risk of heart attacks and arrhythmias.
Diuretics, which reduce fluid in your body and balance sodium and water levels, can help patients with high blood pressure and congestive heart failure. Patients taking diuretics should regularly monitor their kidney function and potassium levels. Common diuretics include:
- Lasix (Furosemide)
- Demadex (Torsemide)
- Hydrochlorthiazide, Bumex (Bumetinide)
- Aldactone (Spirinolactone)
Patients with congestive heart failure may require an ACE inhibitor, with common options including:
- Zestril (Lisinopril)
- Lotensin (Benazapril)
- Capoten (Captopril)
- Accupril (Quinapril)
- Vasotec (Enalapril)
- Altace (Ramipril)
Angiotensin Receptor Blocker
If you cannot tolerate an ACE inhibitor, you can get an ARB such as:
- Cozaar (Losartan)
- Diovan (Valsartan)
- Avapro (Irbesartan)
- Micardis (Telmsartan)
- Benicar (Olmisartan)
Statins lower the risk of heart attack in patients who have experienced myocardial infarction in the past. The most common statins are Zocor (simvastatin), Lipitor (Atorvastatin), Pravachol (Pravastatin) and Crestor (Rosuvastatin).
Fibrates help lower the triglyceride and overall cholesterol levels, and can also help lower the risk of heart attack for patients with coronary artery disease. The most common fibrates are Trico (fenofibrate) and Lopid (Gemfibrozil).
Often used to lower LDL (bad) and raise HDL (good) cholesterol, Niaspan can cause flushing and should be taken with some food. If necessary, patients can take aspirin in conjunction with Niaspan.
Bile Acid Sequestrants
Bile acid Sequestrants help reduce LDL cholesterol. Commonly prescribed options include Welchol (Colesevelam) and Questran (Cholestyramine).
Zetia lowers the rate of intestinal cholesterol absorption. While Zetia can cause gastrointestinal disturbances, most patients tolerate the drug well.