What medication to take after a heart attack

  The decision of what medication to take for heart attack depends on the different stages of the disease. It can be divided into acute phase treatment and stable phase treatment.  In the acute phase of heart attack patients with chest pain, nitroglycerin needs to be administered sublingually immediately. The patient adopts a semi-recumbent position and avoids standing position after taking the drug to avoid the occurrence of postural hypotension. If 2 tablets in a row do not work, the patient should seek medical attention as soon as possible.  In the stable stage, patients with heart attack are treated with antiplatelet, anticoagulation, anti-ischemic drug therapy, cholesterol-lowering therapy and improvement of left ventricular remodeling.  1.Anti-platelet drug therapy Anti-platelet drugs can improve the prognosis by preventing coronary artery in-stent thrombosis leading to another myocardial infarction, and the commonly used drugs include aspirin combined with clopidogrel or tigretol. Aspirin should be taken if there are no contraindications to its use. Clopidogrel is often used in combination with aspirin to reduce in-stent thrombosis, and recent studies have shown that tigretol is recommended instead of clopidogrel for patients with a high risk of in-stent thrombosis.  2. Anticoagulant drug therapy Patients with myocardial infarction are treated with anticoagulant drugs in the acute phase to prevent recurrent myocardial infarction and thus improve prognosis, commonly used drugs include heparin, low molecular heparin and bivalirudin. Patients with stable coronary angina do not require anticoagulation. For patients with coronary artery disease who have stent implantation and atrial fibrillation at the same time, patients who need both antiplatelet and anticoagulation can be combined with warfarin or new oral anticoagulants.  3.Anti-ischemic drug therapy The main drugs to improve ischemia and reduce symptoms include β-blockers and nitrates. β-blockers can block β-adrenergic receptors, thus slowing down heart rate, weakening myocardial contraction, lowering blood pressure, reducing myocardial oxygen consumption and angina attacks, and increasing exercise tolerance. In the absence of contraindications, β-blockers should be used as the initial therapeutic agent for stable angina pectoris. Common drugs include metoprolol, atenolol, bisoprolol, etc. Nitrate drugs can dilate blood vessels, reduce myocardial oxygen consumption, improve myocardial perfusion and relieve angina symptoms. Common drugs are nitroglycerin, isosorbide dinitrate and isosorbide mononitrate, etc.  4.Cholesterol-lowering treatment In addition, the drugs also need to be used are statins, cholesterol-lowering treatment to stabilize plaque, such as atorvastatin, resevastatin, simvastatin, pitavastatin, fluvastatin, etc.  5.Improve left ventricular remodeling therapy Angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists have the effect of improving left ventricular remodeling and should all be routinely applied after myocardial infarction.