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Secondary prevention of myocardial infarction: the roles of β-adrenergic blockers, calcium-channel blockers, angiotensin converting enzyme inhibitors, and aspirin

  • Chapter
Triggering of Acute Coronary Syndromes

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 170))

Abstract

Despite a decline in the incidence of coronary heart disease in the United States, more than 600,000 patients are still being admitted to hospitals annually with a diagnosis of acute myocardial infarction (MI) [1], For patients having their first infarction, there is a 5% in-hospital mortality; the figure is higher for patients with recurrent infarctions [2]. Upon discharge from the hospital, patients continue to have an increased risk of cardiovascular morbidity and mortality. Patients under 70 years of age who survive the inhospital phase of MI have a 10% mortality rate in the first year post discharge, with the highest proportion of deaths occurring in the first three months [2]. Subsequently, there is a 5% annual mortality rate, six times higher than the expected rate in an age-matched population without coronary disease [2]. Approximately 85% of deaths that occur after hospital discharge are related to coronary artery disease, and almost half are sudden deaths. Related to recurrent coronary artery thrombosis, both ventricular tachyarrhythmias and bradyarrhythmias appear to be the primary cause of sudden death.

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Authors
  1. William H. Frishman
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Editors and Affiliations

  1. Institute for Epidemiology, Social and Preventive Medicine, Humboldt University of Berlin, Klinikum Charité, Berlin, Germany

    Stefan N. Willich

  2. Institute for Prevention of Cardiovascular Disease, Deaconess Hospital, Harvard Medical School, Boston, USA

    James E. Muller

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© 1996 Kluwer Academic Publishers

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Frishman, W.H. (1996). Secondary prevention of myocardial infarction: the roles of β-adrenergic blockers, calcium-channel blockers, angiotensin converting enzyme inhibitors, and aspirin. In: Willich, S.N., Muller, J.E. (eds) Triggering of Acute Coronary Syndromes. Developments in Cardiovascular Medicine, vol 170. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1577-0_23

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