Management of post-myocardial infarction patients with left ventricular systolic dysfunction.

After a myocardial infarction (MI), patients are at risk for reinfarction, heart failure (HF), and sudden death. This risk is much higher in patients with left ventricular systolic dysfunction (LVSD). Although post-MI patients with LVSD have an even greater risk of mortality and morbidity, they had been generally excluded from clinical trials. This article reviews recent clinical trials that included post-MI patients with LVSD with or without signs and symptoms of HF. These trials have defined the benefits of pharmacologic management and device therapy in patients who survive an MI in the presence of LVSD.