A 40-year-old male businessman with active lifestyle and no previous habits of smoking of alcohol consumption; came up with signs of sudden chest pain and giddiness.
No past h/o HT/DM/IHD/HF/DKD/CKD or any major surgery like PTCA/CABG/PCI
ECG results showed: ST elevation in inferior leads
2D-Echo-EF%Results: The patient was found to be positive for regional wall motion abnormality with reduced LV systolic function. Ischemic heart disease is the most common cause of wall motion abnormalities. EF – 40%
Patient’s lipid profile showed elevated levels of low density lipoprotein (LDL) and triglycerides. ST elevation in inferior leads by ECG suggested inferior STEMI. 2D-Echo results suggested reduced LV systolic function.
Diagnosis: Acute Coronary Syndrome (ACS), with ST-elevation myocardial infarction (STEMI) and dyslipidemia. Patient was advised Primary Percutaneous Coronary Intervention (PCI).
Post treatment results: This was a classic case of premature ASCVD; early diagnosis and PTCA procedure was successful in removing the stenosis of Right Coronary Artery (RCA).
The Rx on discharge include an Ecosprin AV 75/40mg combination along with anti-platelet Ticagrelor 90mg. Patient was also on anti-hypertensive drugs which include Beta blocker.
Guideline recommendations for management of premature ASCVD:The ESC guidelines 2021, advise in established atherosclerotic disease, the use of aspirin and statin combination e.g., Ecosprin AV; this combination is associated with significant reductions in major vascular events, including stroke and coronary events, and a 10% reduction in total mortality. The benefits outweigh the bleeding hazards posed with antiplatelets.
Conclusion: This is a case of real-world evidence of ASCVD management in a no-risk factor associated patient with an active lifestyle. Antiplatelet combinations such as Ecosprin AV, can be prescribed as per guidelines for secondary preventions for the management of clinically significant ASCVD. The patient after 3 months of PCI and medication is able to play badminton and daily chores while taking care of his business again.
Hypertension
Diabetes mellitus
Dyslipidemia
Smoking
Obesity
Ecosprin AV 75
Ecosprin AV 75/20
Ecosprin AV 75/40
Ecosprin AV 150
Ecosprin AV 150/20
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