Adjunctive Drug Therapy of Acute Myocardial Infarction — Evidence from Clinical Trials

Despite improvement in primary prevention1 and treatment,2 acute myocardial infarction remains the chief cause of death in the United States and most developed countries. Almost half of all victims of myocardial infarction die before they reach the hospital.3 Of several hundred thousand patients hospitalized each year with acute myocardial infarction, 7 to 15 percent die during hospitalization and another 7 to 15 percent die during the following year.4 This article reviews the current evidence from published randomized trials (Table 1) and meta-analyses (Table 2) of adjunctive drug therapy with beta-adrenergic antagonists, angiotensin-converting–enzyme (ACE) inhibitors, nitrates, calcium-channel blockers, antiarrhythmic drugs, and . . .