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Dr. Ramaz Mitaishvili
Editor in Chief, The RMGH WIKI Journal of Medicine and RM Global Health WIKI Core Ramaz Mitaishvili, MD
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Welcome to RMGH Medical Encyclopedia,
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Today's featured article
Guidelines for the Management of Post-MI Patients in the Outpatient Settings
Ramaz Mitaishvili, MD
Gina Gagua, LAc, PhD
Main Points
- Following acute myocardial infarction (MI), patients face a high risk of recurrent cardiovascular events, hospitalizations, heart failure, and mortality.
- Antiplatelet therapy, ß-blockers, angiotensin-converting enzyme (ACE) inhibitors, and statins all reduce cardiovascular risks following acute MI, and their effects are additive.
- In-hospital initiation of aspirin, ß-blocker, ACE inhibitor, and lipid-lowering therapy has been shown to improve treatment rates, long-term patient compliance, and clinical outcomes in patients with acute MI and is now recommended as the standard of care in patients with coronary heart disease.
- Despite these findings and national guidelines, a substantial proportion of post-MI patients is not receiving these medications.
- Reasons for the under-use of these medications include the reluctance of physicians to prescribe ß-blockers to post-MI patients with left ventricular dysfunction and/or symptoms of heart failure; however, recent studies suggest that the ß-blocker carvedilol is safe and effective in these patients.
- Widespread implementation of hospital-based cardiovascular protective treatment–initiation programs for acute MI could dramatically increase treatment rates with these therapies and thus substantially reduce the risk of recurrent cardiovascular events, heart failure, and hospitalizations in the large number of patients admitted for acute MI every year.
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