1. A 67 years old lady was admitted to the coronary care unit with unstable angina. She was wheeled to the cath lab and her coronary angiogram showed a 90% block in the LAD. Other coronary vessels were not blocked significantly. She underwent a percutaneous balloon angioplasty and was wheeled back to the floors. She recovered well and was preparing for a discharge. She was previously on Metformin for her diabetes and fibrate for her raised triglycerides. At this point what modification would be required in her prescription:
1. Stop the fibrate and start her on Atorvastatin 40 mg daily
2. Increase the dose of her fibrate for more aggressive lipid lowering.
3. Stop the metformin and start her on glimepiride
4. Start her on amlodipine for heart protection

Answer: The only important change that is required in her prescription is to start her on a statin. In diabetics statins have been shown to have significant benefits with secondary prevention of coronary artery disease. Increasing the dose of fibrates does not have a similar effect.