[Recommendations for secondary prevention after myocardial infarction].
The new ESC guidelines for secondary prevention after STEMI recommend acetylsalicylic acid, betablockers, ACE inhibitors, statins and as a new therapeutic option 1 g n-3-fatty acids. They also advocate strict control of elevated blood pressure and plasma glucose level. To stop smoking remains obligatory, supplemented by the advice to adhere to a mediterranean diet. The clinical value of using 1 g n-3-fatty acids was shown in the GISSI-P trial and seem to reduce especially arrhythmic events. Considering the number needed to treat for the different pharmacologic therapies, betablockers and ACE inhibitors are essentials if not contraindicated, n-3-fatty acids and statins show each comparable efficacy while acetylsalicylic acid still provides a good cost/benefit relation due to its low price.
Arntz
H-R
HR
Medizinische Klinik II, Kardiologie und Pulmologie, Charité, Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
D002317:Cardiovascular Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control; D038441:Diet, Mediterranean; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control* / Q000534:rehabilitation; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D055502:Secondary Prevention; D015996:Survival Rate; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D015525:Fatty Acids, Omega-3