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Updated: Aug 18, 2026

Perspectives on Neuroscience
Published on: July 31, 2007
What can we learn from Europe?
1Department of Medicine, Sahlgrenska University Hospital/Ostra, Göteborg, Sweden. karl.swedberg@hjl.gu.se
Insights
European guidelines offer strong recommendations for secondary prevention after myocardial infarction. However, evidence-based therapies like beta blockers are underused across Europe, necessitating improved dissemination strategies.
Area of Science:
- Cardiology
- Public Health
Background:
- European Society of Cardiology guidelines provide evidence-based recommendations for managing acute myocardial infarction and chronic heart failure.
- Secondary prevention of complications post-myocardial infarction is crucial, with heart failure and left ventricular systolic dysfunction identified as key risk factors.
Purpose of the Study:
- To evaluate the utilization of secondary prevention treatments across Europe following myocardial infarction.
- To identify variations in treatment use among European countries and assess the underutilization of evidence-based therapies.
Main Methods:
- Analysis of survey data evaluating the use of secondary prevention treatments in European countries.
- Review of specific initiatives aimed at disseminating evidence-based secondary prevention strategies.
Main Results:
- Significant variation exists in the use of secondary prevention treatments across European nations.
- Evidence-based therapies, including beta blockers and angiotensin converting enzyme inhibitors, are generally underutilized.
Conclusions:
- Despite clear guidelines, the adoption of evidence-based secondary prevention post-myocardial infarction in Europe remains suboptimal.
- Successful dissemination strategies, exemplified by the Italian BRING-UP collaboration and the Swedish RIKS-HIA registry, can improve the utilization of critical treatments like beta blockers.
Abstract:
The European Society of Cardiology has produced guidelines for the treatment of acute myocardial infarction as well as for chronic heart failure and for the use of beta blockers and angiotensin converting enzyme inhibitors. These documents provide clear evidence and strength of recommendations for the secondary prevention of complications after a myocardial infarction. The identification of heart failure and left ventricular systolic dysfunction are important risk factors in this context. The use of secondary prevention treatments in Europe has been evaluated in several surveys. The use of treatments varies across the participating countries and evidence based therapies in general are under-utilised. Various approaches have been taken to disseminate evidence based secondary prevention. Experience from the Italian BRING-UP collaboration illustrates how the use of beta blockers can be increased. Similarly, the Swedish RIKS-HIA registry of acute myocardial infarction has increased the use of secondary preventive treatments.
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