Management of patients after primary percutaneous coronary intervention for myocardial infarction

#### What you need to know For those who present with an acute ST elevation myocardial infarction (STEMI) in the UK, nearly 90% are treated with a primary angioplasty within 90 minutes of arrival at hospital.1 One out of every seven deaths is due to coronary heart disease, with one person having a “heart attack” every 40 seconds, based on US data.2 In the UK, 288 per 100 000 people visit hospital with a suspected heart attack each year.3 Patients are usually discharged three days after treatment for a STEMI with an uncomplicated primary percutaneous coronary intervention (PCI).1 4 They may present in the community for further advice shortly after discharge, so close collaboration between the cardiologist and the wider healthcare team is essential.5 This article provides an update on the immediate and longer term management of such patients (see fig 1⇓). Fig 1  Management of patients after an acute ST elevation myocardial infarction #### Sources and selection criteria We searched PubMed, Cochrane Library, Medline, and Google using the terms “secondary prevention after a myocardial infarction,” “secondary prevention after a heart attack,” …