A 71-year-old man with known coronary artery disease (CAD) comes to your office for a routine visit. He was diagnosed with CAD 17 years ago after experiencing an anterior wall myocardial infarction (MI) requiring 4 stents in the left anterior descending (LAD) artery. His ejection fraction has remained at 60% since his MI. Other history includes asthma, hypertension (HTN), and type 2 diabetes (T2D). He says he has no symptoms of chest pain, palpitations, or shortness of breath with exertion, or T2D-related end-organ symptoms.

He is currently taking amlodipine 5 mg/d, aspirin 81 mg/d, losartan 25 mg/d, metoprolol 12.5 mg bid, rosuvastatin 10 mg/d, and extended-release metformin 2000 mg/d. He takes his medications as prescribed, is following a heart-healthy diet, and does not smoke.

His low-density lipoprotein (LDL) cholesterol concentration is 67 mg/dL. Last year, his hemoglobin A1C was 6.1%, and this year, it is 6.7%. His estimated glomerular filtration rate (eGFR) is 70 mL/min/1.73m². His physical examination is unremarkable.