A 62-Year-Old Man with a History of Dyslipidemia and Type

question 595

Multiple Choice

A 62-year-old man with a history of dyslipidemia and type 2 diabetes mellitus comes to the emergency department due to severe substernal chest pain and diaphoresis that began 2 hours ago.  His ECG shows ST- segment elevation in leads V1 to V4.  He is taken to the cardiac catheterization lab and a complete occlusion of the mid-left anterior descending artery (LAD) is diagnosed.  A drug-eluting stent is placed in the LAD with complete restoration of flow, and the patient is started on aspirin and clopidogrel.  On the third day of hospitalization, the option of adding rivaroxaban is discussed with the patient.  He asks about the benefits and risks of the added therapy.  Based on the research abstract, which of the following measures would best reflect the net clinical benefit of rivoraxaban?

• A)"Death from any cause/myocardial infarction/stroke" and "intracranial hemorrhage"
• B)"Death from cardiovascular causes" and "fatal bleeding"
• C)"Death from myocardial infarction" and "TIMI bleeding requiring medical attention"
• D)"Intracranial hemorrhage" and "fatal bleeding"
• E)"Primary efficacy endpoint" only

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Definitions:

Counseling

A professional relationship and process that helps individuals, couples, or groups effectively address personal, social, or psychological challenges.

Double-blind Studies

Research designs in which neither the participants nor the experimenters know who is receiving the treatment, to prevent bias.

Placebo Effect

The phenomenon in which people experience a perceived benefit from a treatment that has no therapeutic effect, attributed to the individual's belief in the treatment's efficacy.

Diffusion Of Responsibility

A sociopsychological phenomenon wherein a person is less likely to take responsibility for action or inaction when others are present.