Practical guidelines for drug therapy after myocardial infarction.

Effective management of the postinfarction patient includes early assessment of direct complications such as angina pectoris, congestive heart failure and ventricular arrhythmias. Treatment of persistent ischaemia might call for early revascularisation. Early prevention of reocclusion with aspirin is recommended. It is advisable to correct blood lipid disturbances and to treat elevated blood pressure. beta-Blocking drugs have shown worthwhile reductions of both non-fatal and fatal recurrences, whereas calcium blockers and antiarrhythmic drugs have not been found to be effective. Anticoagulants have not been definitely effective in reducing mortality but seem to have some effects on non-fatal recurrences. Platelet active drugs, among which aspirin is the best documented, reduce the incidence of both non-fatal and fatal recurrences.