2. Preventive Therapy
An enteric-coated aspirin tablet is given to virtually all patients with angina or CAD in an effort to prevent fatal or nonfatal infarction. A timely Veterans Administration study utilizing 324 mg of aspirin in patients with unstable angina resulted in a 50% reduction in mortality rate and nonfatal myocardial infarctions. In another randomized study, aspirin was shown to reduce the cardiac mortality rate by 50% in patients with unstable angina. A Swedish study using 75 mg of aspirin in patients with stable angina showed a 34% reduction in infarctions and death. In patients who are allergic or intolerant to the use of aspirin, clopidogrel bisulfate (Plavix) is recommended.
E. Statins
Statins are well-known cholesterol-lowering agents that have proved, in randomized controlled trials, to prevent serious cardiac events in patients with CAD. Fatal and nonfatal infarctions are prevented in patients with stable or unstable angina.
Available statins include atorvastatin, fluvastatin, pravas-tatin, simvastatin, and the recently introduced more powerful statin, rosuvastatin. Statins are recommended for all patients with stable or unstable angina to main¬tain low-density lipid (LDL) cholesterol levels at less than 80 mg/dl (2.0 mmol/L), see the section under Dyslipidemia.

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