Writing the discharge prescription for the myocardial infarction survivor

More victims of myocardial infarction (MI) are surviving to discharge, but their chances for long-term survival are being undercut by an underuse of sensible preventive therapy. With few exceptions, patients who have had an MI should receive a minimum preventive prescription of aspirin, a β-blocker, and an angiotensin-converting enzyme inhibitor; nonpharmacologic measures to reduce lipid levels should be instituted as well. Ironically, many patients who could benefit most from β-blocker therapy do not receive it. The addition of lipid-lowering drugs, anticoagulants, or antioxidants may be prudent for some patients. The benefits of other agents, such as calcium channel blockers or estrogen, are either unsubstantiated or doubtful at this time.