Risk factor intervention and prognosis after acute myocardial infarction.

The review is restricted to the three main risk factors of ischemic heart disease (IHD): cholesterol, blood pressure, and smoking. It deals with the question of whether these risk factors continue to affect prognosis after a first MI, without tackling the problem of how successful risk factor modification can be. Thus, neither primary nor secondary prevention trials are analyzed. The evidence from large, well conducted prospective studies shows that, although relative risk is greater prior to MI than thereafter, absolute risk is higher post-MI because of higher overall mortality. Although clinical characteristics and consequences of the acute event have a stronger prognostic power, it is still worthwhile to correct risk factors post-MI for a number of reasons.