Increasing prescription of drugs for secondary prevention after myocardial infarction

Mortality from acute myocardial infarction is reduced after treatment in the recovery period by the selective use of aspirin, β blockers, warfarin, and angiotensin converting enzyme inhibitors.1 Despite evidence from trials, the use of β blockers has not been translated into clinical practice.2 Most patients with myocardial infarction are managed by general physicians and general practitioners, but immediate coronary care is increasingly complex and the choice of drug for secondary prevention has increased, adding to the confusion. Cardiologists need to guide management decisions without necessarily taking over complete care of patients with cardiovascular disease. We audited the use of drugs for secondary prevention before and after an intervention aimed at increasing their use. About 75% of patients with suspected myocardial infarction are admitted to the coronary care unit3 and managed by the admitting medical firm according to guidelines provided by the cardiologist. On a daily ward round the consultant cardiologist supervises management, but on discharge …