Authors' objectives:

To produce clinical practice guidelines on prophylaxis for patients who have experienced a myocardial infarction, in terms of drug treatment, cardiac rehabilitation and dietary manipulation.

Authors' recommendations: For patients with uncomplicated previous myocardial infarction, treatment should be offered to patients, initially with a beta-blocker and aspirin, and then with a statin and an ACE inhibitor. Referral for cardiac rehabilitation (with a substantial exercise component) should be offered, if not initiated, in hospital. For patients with previous myocardial infarction and heart failure, treatment should be offered to patients, initially with ACE inhibitor, and then a beta-blocker. Patients with moderate to severe heart failure should additionally be offered spironolactone. There is evidence to suggest value in a Mediterranean diet in patients with prior myocardial infarction and insulin therapy in the post-acute phase in patients with diabetes, although it has not been possible to assess the cost-effectiveness of these interventions.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.nice.org.uk/cat.asp?c=20053

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: National Institute for Clinical Excellence

Contact Address: MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Clinical Excellence (NICE)