Secondary Prevention of Myocardial Infarction

  • Jorge Plutzky
Part of the Contemporary Cardiology book series (CONCARD)


The patient who survives a first myocardial infarction (MI) now faces an approximately 80% chance of some cardiovascular event within the next 5 years (1), having doubled their chances of dying from such an event (2). Thus informing patients that they have had a heart attack is not unlike telling them they have cancer. Surprisingly, the reaction of many patients to these pronouncements appears to be quite different, perhaps because of antiquated notions, propagated at times by physicians, that cardiac therapy (bypass surgery, angioplasty) can “fix” the problem. Perhaps these responses arise from knowledge of the many therapeutic interventions available to cardiologists and their patients. In reality, modern medicine is better at “curing” cancer than eradicating atherosclerosis. Physicians today may be more sanguine about the complex nature of atherosclerosis, a nature that makes it a recurrent problem for most patients. We are left with using every tool available in an attempt to modify the natural history, whittling away at those ominous percentages that an MI survivor faces. Fortunately, the number of interventions (medical and otherwise) for secondary prevention continues to grow. Similarly, our understanding of atherogenesis and MI is also deepening, creating hope for the developments of new, and perhaps more effective, therapies, for example, gene therapy, plaque stabilizers, and radial artery bypass.


Hormone Replacement Therapy Secondary Prevention Coronary Artery Disease Patient Nurse Health Study Scandinavian Simvastatin Survival Study 
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© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Jorge Plutzky

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