Treatment after myocardial infarction.

Abstract

Persons after myocardial infarction (MI) should have their modifiable coronary artery risk factors intensively treated. Hypertension should be treated with beta blockers and angiotensin-converting enzyme (ACE) inhibitors. The blood pressure should be reduced to <140/90 mmHg and to <130/80 mmHg in persons with diabetes or renal insufficiency. The serum low-density lipoprotein cholesterol should be reduced to <70 mg/dl with statins if necessary. Diabetics should have their hemoglobin A1c reduced to <7.0%. Aspirin or clopidogrel, beta blockers, and ACE inhibitors should be given indefinitely unless contraindications exist to the use of these drugs. Long-acting nitrates are effective antianginal and antiischemic drugs. Postinfarction patients at very high risk for sudden cardiac death should have an implantable cardioverter-defibrillator. The two indications for coronary revascularization are prolongation of life and relief of unacceptable symptoms despite optimal medical management.

• Authors: Wilbert S Aronow
• Journal: Comprehensive therapy (Compr Ther) Vol. 33 Issue 1 Pg. 39-47 ( 2007) ISSN: 0098-8243 [Print] United States
• PMID: 17984493 (Publication Type: Journal Article, Review)

Topics

• Aged
• Defibrillators, Implantable
• Diabetes Mellitus (drug therapy)
• Diet Therapy
• Exercise
• Female
• Humans
• Hyperlipidemias (complications, therapy)
• Hypertension (complications, therapy)
• Male
• Myocardial Infarction (complications, drug therapy, surgery, therapy)
• Myocardial Revascularization
• Obesity (complications, therapy)
• Smoking Cessation