What is the best choice for the prevention of coronary artery disease in elderly patients?

The best choice for the prevention of coronary artery disease in elderly patients among the options presented is enteric-coated aspirin (ASA). Aspirin plays a crucial role in the prevention of cardiovascular events due to its antiplatelet properties. In elderly patients at risk for coronary artery disease, daily low-dose aspirin has been shown to significantly reduce the incidence of myocardial infarction and other cardiovascular events by inhibiting platelet aggregation.

Enteric-coated formulations are beneficial in this population as they are designed to dissolve in the intestines rather than the stomach, which can help minimize gastrointestinal irritation—a common side effect of uncoated aspirin, particularly in older adults who might have increased gastrointestinal sensitivity.

While other options like warfarin and clopidogrel also have roles in cardiovascular risk management, they are typically not first-line agents for primary prevention of coronary artery disease. Warfarin is mainly used for atrial fibrillation and prevention of thromboembolic events, whereas clopidogrel is often utilized in patients who have already experienced acute coronary events or require stent placement. Dipyridamole-ASA is used in certain settings, but it is not as widely recommended for primary prevention as low-dose aspirin.

Thus, enteric-coated aspirin stands out as the