Cardiologist Questions Cardiologist

Medication after a stemi and stent placement?

I had a stemi with a stent placement to my RCA. Post procedure I did have some hypertension which now I am taking metoprolol and lisinopril also on effient and a baby aspirin. My echocardiogram was negative with an EF of 60 and no regurgitation my CK and trop or negative showing no signs of cardiac damage having made it to the Ed in time. My question is why do I need to take Lisinopril for afterload if there's no cardiac damage the same question asked for the metoprolol being the beta blocker. I do understand that I need to take effient and baby aspirin because of the stent.

Male | 56 years old
Complaint duration: 7
Medications: Lisinopril, metoprolol, Effient, baby aspirin
Conditions: Stemi

4 Answers

The fact that thankfully there was no damage to the myocardium (preserved EF after RCA stenting) does not change the fact that you are affected by coronary artery atherosclerosis. Beta blockers and aspirin are a required medication to reduce the risk of future adverse cardiac events. Hypertension is one of the main risk factor for occurrence and progression of coronary atherosclerosis, therefore it has to be well controlled, along with the other major risk factors, such as hypercholesterolemia, smoking, obesity, etc. For this reason, the use of lisinopril is indicated. The objective is to obtain adequate control of BP by the afterload reduction effect that you are mentioning.
I hope this helps. Please, notice that moderate physical activity is an important factor to also prevent the occurrence of adverse cardiac events.
This is an ace inhibitor. Helps to lower BP especially with a history of coronary arteries disease. Your EF is good, that is nice, but you still don’t want too much strain on your heart muscle. Finally, it reduces death rate following a heart attack because of the afterload reduction.
Good luck.
B- blocker is good. However if your BP is stable your physician may take off other medications. Continue baby aspirin.
Metoprolol is mainly for your heart to keep your heart rate low, not nescessarily blood pressure. If your blood pressure is still 130/80 or above when you first wake up, it is still uncontrolled. Discontinue Lisinopril and start Benicar. Yes, you have to be on blood thinners, normally ASA and Plavix.