The Canadian journal of cardiology
-
This overview summarizes the pathophysiology of acute myocardial infarction and reviews existing strategies for secondary prevention of myocardial infarction. The review also examines the complex interactions among lipids and the hemostatic/fibrinolytic systems to delineate the importance of lipid reduction as a secondary prevention measure. ⋯ Atherosclerotic plaque rupture with occlusive thrombus formation is integral to the pathophysiology of acute myocardial infarction. Beta-blockers, acetylsalicylic acid, warfarin, and angiotensin-converting enzyme inhibitors are useful agents for secondary prevention. The myriad deleterious effects of hyperlipidemia that promote a prothrombotic and antifibrinolytic vascular milieu serve to elucidate the importance of lipid reduction as an additional secondary prevention measure.