A 59-year-old woman with type II diabetes mellitus experiences an episode of chest pain with exercise. On examination, her BMI is 30. Angiography reveals proximal coronary arterial narrowing with up to 70% stenosis. Which of the following pharmacologic agents ingested in low doses daily is most appropriate for reducing her risk for myocardial infarction?
Aspirin (acetylsalicylic acid) inhibits the cyclooxygenase pathway of arachidonic acid metabolism and inhibits platelets that participate in thrombogenesis. When atheromatous plaques have progressed to the point of symptomatic occlusion and subsequent angina, they are likely to be unstable plaques that may rupture, ulcerate, or erode to promote thrombosis. A "baby" aspirin-containing 80 mg (325 mg in the "adult" tablet) taken once a day may reduce this thrombotic risk, and also prevent the significantly increased risk for hemorrhage that is associated with higher doses. Acetaminophen is primarily analgesic in action. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that has no significant effect upon atheroma progression. Paclitaxel is one type of drug (initially used as an anticancer agent) used in drug-eluting stents placed in coronary arteries following angioplasty to deter restenosis. Propranolol is a beta-blocker that is employed as an antihypertensive agent.
Acetaminophen
Aspirin
Ibuprofen
Paclitaxel
Blood Vessels