Cardiac Medicine Certification (CMC) Practice Exam

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What is the antiplatelet medication commonly used after a NSTEMI to prevent reocclusion of stents?

  1. Warfarin

  2. Aspirin

  3. Clopidogrel (Plavix)

  4. Beta-blockers

The correct answer is: Clopidogrel (Plavix)

In the context of managing patients following a Non-ST-Elevation Myocardial Infarction (NSTEMI) and the placement of a stent, Clopidogrel (Plavix) plays a crucial role in preventing stent reocclusion. Following the acute event, antiplatelet therapy is essential to inhibit the activation and aggregation of platelets, which can lead to the formation of thrombus (clots) at the site of the stent and result in blockage. Clopidogrel is a thienopyridine that works by irreversibly inhibiting the P2Y12 receptor on platelets, which is critical for platelet activation and aggregation. When combined with aspirin, which inhibits the cyclooxygenase (COX) enzyme and decreases thromboxane A2 production, this dual antiplatelet therapy significantly enhances protection against thrombus formation after stent placement. While aspirin also serves as an important component of post-stenting therapy, it is the specific role of Clopidogrel in directly preventing platelet activation and thus reocclusion that makes it particularly significant in this scenario, especially when considering clopidogrel's synergistic effect with aspirin. Other options, such as warfarin and beta-block