Secondary prevention after acute myocardial infarction and coronary revascularisation: focus on Angiotensin converting enzyme inhibitors.

INTRODUCTION: Cardiovascular disease (CVD) is responsible for an estimated one third of all deaths worldwide. PATIENTS AND METHODS: One group of patients who are at a particularly high risk of cardiovascular events and death are those with stable coronary artery disease (CAD), especially if they have had a previous myocardial infarction (MI) or revascularisation. DISCUSSION: Lifestyle changes (smoking, alcohol intake, diet, exercise) and cardiac rehabilitation play an important part in reducing risk of recurrent events. In patients with a history of MI and/or those who underwent myocardial revascularisation these have to be supplemented with medication. Several pharmacological agents are known to improve prognosis in these patients, i.e. beta-blockers, antiplatelet agents, statins, and angiotensin converting enzyme inhibitors (ACEi). The present article focuses mainly on the role of ACEi in the prevention of cardiovascular events in patients with a history of MI or myocardial revascularization.