American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended daily medication for patients with giant cell arteritis to reduce their cardiovascular risk?

1. Daily low-dose aspirin

2. Daily corticosteroids

3. Daily non-steroidal anti-inflammatory drugs (NSAIDs)

4. Daily methotrexate

The correct answer is: Daily low-dose aspirin

Daily low-dose aspirin is the recommended medication for patients with giant cell arteritis to reduce their cardiovascular risk. Giant cell arteritis, also known as temporal arteritis, is associated with an increased risk of cardiovascular events due to underlying systemic inflammation. Aspirin serves a critical role in this context as it has antiplatelet properties that can help reduce the risk of thrombosis, which is a concern in these patients, given the higher likelihood of vascular complications. Moreover, aspirin is often used concurrently with corticosteroids, which are the primary treatment for managing the inflammatory aspects of giant cell arteritis. While corticosteroids effectively address the inflammatory process and reduce symptoms, they do not specifically target cardiovascular risk factors. Thus, adding low-dose aspirin can significantly mitigate the risk of cardiovascular diseases, including stroke and myocardial infarction, which can be potential complications of the condition. The other options, while having their specific uses in different contexts—such as corticosteroids for inflammation control, NSAIDs for symptom relief, and methotrexate as a disease-modifying agent—do not provide the specific cardiovascular protective benefits that low-dose aspirin does in patients with giant cell arteritis.