Pharmacotherapy following myocardial infarction--a review of current treatment practices.
Modern treatment of acute myocardial infarction (AMI), including thrombolysis and early interventional strategies, has reduced mortality rates but increased the number of patients requiring medical treatment. Post infarction treatment with aspirin, statins, beta-blockers and angiotensin-converting enzyme (ACE) inhibitors has improved morbidity and mortality and is cost-effective. The major successes of secondary prevention have been seen in the prevention of reinfarction, recurrent ischaemia and the development of heart failure. However, in spite of recent advances and increasing knowledge, the mortality rates remain high, partly due to the under use of the established and documented medical strategies. Implementation of the current treatment strategies into general practice remains a challenge. The field is undergoing rapid change due to the increasing use of early invasive strategies. The primary objective should remain the prevention of underlying aetiology: coronary artery disease (CAD). Secondary prevention following myocardial infarction (MI) will remain a major challenge in clinical practice within the foreseeable future.
Cardiology Division, Central Hospital, Rogaland, N-4003 Stavanger, Norway.
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Dickstein
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000818:Animals; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000517:prevention & control
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000924:Anticholesteremic Agents; D000925:Anticoagulants; D005343:Fibrinolytic Agents