Mortality from coronary heart disease has been falling in the UK since the 1970s, but remains higher than in most other Western countries. Most patients receive some treatment for secondary prevention after myocardial infarction, but not all patients are offered the most effective secondary prevention package. The recently published NICE guideline for secondary prevention in patients after myocardial infarction, summarised in this article, makes clear recommendations for management of patients after myocardial infarction, based on best available evidence. The guidelines update the 2001 NICE guideline, and have expanded and emphasised the recommendations for physical activity, dietary and other lifestyle changes, and cardiac rehabilitation, and updated the recommendations for drug therapy.
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Funding: The National Collaborating Centre for Primary Care was commissioned and funded by the National Institute for Health and Clinical Excellence to write this summary.
Competing interests: All authors were members of the Guideline Development Group for the NICE guideline for secondary prevention after myocardial infarction. Dr Skinner was the clinical advisor, Dr Cooper the lead systematic reviewer and Professor Feder chaired the guideline development group. During the last 5 years Dr Skinner has received travel grants to attend educational meetings from Novartis, Pfizer and Sanofi Synthelabo/Bristol Myers Squibb Pharmaceuticals, with none during the last 2 years.
Declaration: A similar summary of this guideline has also been published in the BMJ2007;:–13 .