Secondary prevention trials after myocardial infarction.

Secondary prevention trials after myocardial infarction have been compared and reviewed. The data suggest that beta-blockers particularly those without intrinsic sympathomimetic activity (ISA) improve long-term survival after myocardial infarction. Platelet-active drugs reduce the rate of reinfarctions and may have a beneficial effect on survival. In contrast lipid-lowering regimens, anticoagulants, calcium channel blockers, and antiarrhythmics have not shown convincing beneficial effects on survival thus far. Difficulties with subgroup analysis and statistical evaluation of treatment effects are discussed.