Comprehensive secondary prevention following myocardial infarction, including dual antiplatelet therapy, statins, and lifestyle modifications, is recommended to reduce the risk of recurrent events.
A clinical update highlighting the crucial role of GPs in secondary prevention after MI, noting that >80% of STEMI patients in the UK receive primary PCI.
Better secondary prevention after myocardial infarction (MI) could prevent over 30 000 deaths a year in England and Wales.1 GPs have a crucial role and should be aware of recent changes in recommended antiplatelet therapy. There is no ‘one-size-fits-all’ secondary preventative drug regimen, owing to the ranging presentations of MI (ST-segment elevation STEMI and non-ST-segment elevation NSTEMI), the timing of reperfusion therapy (emergency versus urgent percutaneous coronary intervention PCI or coronary artery bypass surgery CABG), and the range of comorbidities (such as, heart failure, atrial fibrillation, or hypertension). Currently in the UK, >80% of STEMI patients receive primary PCI, with <1% receiving urgent CABG. Among NSTEMI patients, more than 90% receive some form of anticoagulation and approximately one- third undergo revascularisation (Box 1).2 Box 1. ### UK reperfusion recommendations and antiplatelet therapya | Role | Details | Comment | |:------- | ------- | -------------------------------------------------------------------------- | | STEMI5 | | Aspirin 75 mg daily for life plus: ticagrelor 90 mg twice daily for a year | | NSTEMI6 | |
Isted et al. (Thu,) conducted a review in Myocardial infarction. Secondary prevention (pharmacological and lifestyle) was evaluated. Comprehensive secondary prevention following myocardial infarction, including dual antiplatelet therapy, statins, and lifestyle modifications, is recommended to reduce the risk of recurrent events.