March 1, 1998Open Access
View Full PaperPathophysiologic bases for adjunctive therapies in the treatment and secondary prevention of acute myocardial infarction
Structured PICO
Do adjunctive medical therapies improve survival in the treatment and secondary prevention of acute myocardial infarction?
P
Population
Patients with acute myocardial infarction (treatment and secondary prevention)
I
Intervention
Adjunctive medical therapies (aspirin, beta blockers, angiotensin-converting enzyme inhibitors, lipid-lowering agents, nitrates, magnesium, antiarrhythmic agents, calcium-channel blockers)
O
Outcome
Survival/mortalityhard clinical
Aspirin, beta blockers, ACE inhibitors, and lipid-lowering agents are effective adjunctive therapies that improve survival post-myocardial infarction, while magnesium, antiarrhythmics, and calcium-channel blockers do not.
Abstract
Postmyocardial infarction (MI) survival has been steadily improving. This improvement has been due, in part, to the actions of the adjunctive medical therapies for the treatment of MI. Aspirin, beta blockers, angiotensin-converting enzyme (ACE) inhibitors, and lipid-lowering agents have been shown to improve survival in the treatment and secondary prevention of MI. Nitrates have beneficial effects as well. These medications complement the reperfusion strategies through different mechanisms. Other adjunctive medical therapies, namely magnesium, antiarrhythmic agents, and calcium-channel blockers, have not been shown to improve mortality with routine post-MI use despite their theoretical benefits.