Challenges in secondary prevention after acute myocardial infarction: A call for action.
Worldwide, each year more than 7 million people experience myocardial infarction, in which one-year mortality rates are now in the range of 10%, but vary with patient characteristics. The consequences are even more dramatic: among patients who survive, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of ischaemic heart disease. The people behind these numbers spur this call for action. Prevention after myocardial infarction is crucial to reduce risk and suffering. Evidence-based interventions include optimal medical treatment with anti-platelets and statins, achievement of blood pressure, lipid and blood glucose targets, and appropriate lifestyle changes. The European Society of Cardiology and its constituent bodies are determined to embrace this challenge by developing a consensus document in which the existing gaps for secondary prevention strategies are reviewed. Effective interventions in relation to the patients, healthcare providers and healthcare systems are proposed and discussed. Finally, innovative strategies in hospital as well as in outpatient and long-term settings are endorsed.
1 Cardiac Department, Guglielmo da Saliceto Polichirurgico Hospital AUSL Piacenza, Italy.
Massimo F
MF
Piepoli
2 Cardiology Rehabilitation Division, Scientific Institute of Veruno, Italy.
Ugo
U
Corrà
3 Department of Cardiology, Jessa Hospital, Hasselt, Belgium.
Paul
P
Dendale
4 Heart Centre Hasselt, University of Hasselt, Belgium.
Ines
I
Frederix
5 Department of Cardiology, University of Copenhagen, Denmark.
Eva
E
Prescott
6 Department of Cardiology, Spital Tiefenau, Bern, Switzerland.
Jean Paul
JP
Schmid
7 Department of General Practice and Primary Care, Queen's University Belfast, UK.
Margaret
M
Cupples
8 Florence Nightingale Foundation, Cambridge University Hospitals NHS Foundation Trust, UK.
Christi
C
Deaton
9 Cardiovascular Health Department, University of York, UK.
Patrick
P
Doherty
2 Cardiology Rehabilitation Division, Scientific Institute of Veruno, Italy.
Pantaleo
P
Giannuzzi
10 Trinity College, University of Dublin, Ireland.
Ian
I
Graham
11 Zealand University Hospital, Roskilde, Denmark.
Tina Birgitte
TB
Hansen
12 Department of Cardiovascular Medicine, Imperial College London, UK.
Catriona
C
Jennings
13 Department of Cardiology, Charite Universitätsmedizin Berlin, Germany.
Ulf
U
Landmesser
14 Department of Internal Medicine, Lausanne University Hospital, Switzerland.
Pedro
P
Marques-Vidal
15 Department of Cardiology, University of Antwerp, Belgium.
Christiaan
C
Vrints
16 Department of Cardiology, East Sussex Healthcare NHS Trust, UK.
David
D
Walker
17 Cardiology Department, Universidad Complutense de Madrid, Spain.
Héctor
H
Bueno
18 University of Ulster, Belfast Trust Northern Ireland, UK.
Donna
D
Fitzsimons
19 Institute of Sport Medicine and Science, Comitato Olimpico Nazionale Italiano, Italy.
Antonio
A
Pelliccia
D002309:Cardiology / Q000379:methods*; D014943:Global Health; D006801:Humans; D008019:Life Style; D009017:Morbidity / Q000639:trends; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control*; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*
Cardiovascular prevention; cardiac rehabilitation; exercise training; healthcare systems; myocardial infarction; pharmacological therapy; risk factors