Why read this summary?

Although premature mortality from coronary heart disease in the United Kingdom has fallen since the 1970s, it remains higher than in most other Western countries. After an acute myocardial infarction, many eligible patients are prescribed aspirin, β blockers, angiotensin converting enzyme inhibitors, and statins. Not everyone, however, is offered the most effective secondary prevention1 2—that is, all four of these drugs or other effective drugs—nor does everyone receive lifestyle advice and cardiac rehabilitation. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on effective secondary prevention in patients after myocardial infarction.3 The detailed consideration of the evidence is available in the full guideline (www.nice.org.uk/CG048).

Recommendations

NICE recommendations are based on systematic reviews of best available evidence. For the guidance on secondary prevention for patients after a myocardial infarction, in cases where minimal evidence was available, the guideline development group developed the recommendations on the basis of their own opinions and those of leading specialists; such recommendations are indicated with an asterisk (*).

Every discharge summary after a myocardial infarction should confirm this diagnosis and include results of investigations, future management plans, and advice on secondary prevention.*