[Secondary prevention following myocardial infarction may be improved. Long-term medication use according to practice...

To determine the percentage of myocardial infarction patients in the Netherlands still using medication for secondary prevention according to current practice guidelines at the long term.

Follow-up study of a prospective randomised clinical trial.

From 1071 myocardial infarction patients participating in a trial we obtained data on long-term medication use during follow-up. The medication was compared with the recommendations of the European Society of Cardiology for the use of statins, antithrombotics, renin-angiotensin-aldosterone system inhibitors and beta-blockers.

From 922 patients (86%) data were available on the medication use at on average 36 months (SD: 7) after myocardial infarction. At that time, 51% of the patients used medication conformable to the guideline. The use of ACE-inhibitors or angiotensin II-receptor blockers was lowest (71% of all patients). At discharge from the hospital the patient group using medication according to the guideline during long-term follow-up had significantly more often received medication conformable to the guideline.

Approximately half of the patients with myocardial infarction still adhere to use of medication for secondary prevention according to current guidelines at the long term. In particular, adherence of the cardiologist prescribing medication at discharge deserves more attention.