After state of the art treatment for his heart attack, Mr. X 49 years of age was meticulous in his lifestyle management and compliance with his drug schedule.

Mrs. Y , 64 years old, had stroke. Reached hospital on time. Received the best of treatment. Was religiously following post discharge recommendations.

Both had heart attacks again within a year !!

All laboratory tests were normal and blood pressure, cholesterol levels and blood sugar were at the target levels as well.

RESIDUAL RISK. This phenomenon is explained by residual risk. This is the risk that remains after current evidence based treatment and control of the conventional risk factors.

What needs to be done.

These high risk individuals need to be identified and additional measures with newer drugs such as oral anticoagulants, triglyceride lowering drugs, lipoprotein (a) lowering drugs, SGLT2 inhibitors and colchicine can be initiated .

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