Secondary prevention in myocardial infarction survivors

This report is the outcome of a meeting held on May I and 2, 1980, at Kronberg/Taunus, West Germany, under the sponsorship of the International Society and Federation of Cardiology. The participants were representatives of three Scientific Councils (Arteriosclerosis, Epidemiology and Prevention, and Rehabilitation). The purpose of the meeting was to formulate recommendations for physicians on the secondary prevention of coronary heart disease, particularly among survivors of myocardial infarction. Too often such patients receive inadequate follow-up after recovery from the acute illness. We believe that planned and sustained care can substantially improve their rehabilitation and prognosis. Our advice, reached after careful and extensive discussion, represents a consensus based on currently available evidence. This is an exciting and rapidly changing field, with much research in progress and more needed. I t is hoped that this research will in due course clarify some of the issues which we have had to leave in doubt, notably with regard to the use of beta blockers and platelet-active drugs. We wish to emphasize two points. Firstly, secondary prevention must be seen as a continuation of primary prevention, whose importance is generally heightened because these patients are at particular risk; it forms one important part of an overall control strategy. Secondly, although our report is arranged according to individual risk factors and drugs, every patient must be considered as a whole. For each survivor of myocardial infarction the physician should plan an overall policy, both short-term and long-term.