Improving outcomes in the post-myocardial infarction setting.

Heart disease is the leading cause of death in the United States, with African-American men having the highest rate of cardiovascular mortality in the US population. Although the clustering of multiple cardiovascular risk factors is particularly apparent in this group, a key reason for the higher rate of cardiovascular mortality among African-American men compared with other ethnic groups may be related to underdiagnosis and undertreatment. Studies have shown that minority persons with myocardial infarction are less likely than non-minorities to be diagnosed, to receive appropriate drug therapy, or to undergo bypass surgery. However, there are no data that suggest established treatments and secondary prevention strategies are less effective in African Americans. Appropriate therapy for secondary prevention--including thrombolysis, antiplatelet strategies, angiotensin-converting enzyme inhibition, beta blockade, and lipid-lowering therapies--results in significant reductions in mortality for all patients.