Fortnightly review: Secondary prevention in acute myocardial infarction

BMJ 1998;316:838-842 ( 14 March )

Clinical review

Fortnightly review

Secondary prevention in acute myocardial infarction

Rajendra H Mehta, cardiology fellow, Kim A Eagle, chief of clinical cardiology.

University of Michigan Hospital, Division of Cardiology, Taubman Center 3910, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0366, USA

Correspondence to: Dr Eagle

The first 150 words of the full text of this article appear below.

Acute myocardial infarction affects hundreds of thousands of people each year. Around a quarter die, half of them before reachinga hospital. Survivors are at increased risk of recurrent myocardialinfarctions or cardiac death, with a 10% death rate in the firstyear after discharge and a subsequent annual death rate of 5% $---$ sixtimes that in people of the same age who do not have coronaryartery disease. Whereas aggressive management of the acute infarctionhas been enthusiastically adopted, far less attention has beengiven to preventive strategies. Though most doctors agree withthe importance of secondary prevention, the results of studiessuggest that many patients are currently not being given optimalpreventive care. Since most patients after acute myocardial infarctionare routinely followed up in primary care, general practitionersmust be fully informed and participate in treatment strategiesdesigned for the secondary prevention of coronary artery disease.

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