[Second prevention following myocardial infarct]

The prophylactic effect of beta-blockers in reducing reinfarction and cardiac death after acute myocardial infarction has been proven convincingly in several studies. Whereas anticoagulation is not generally accepted in secondary prophylaxis, it has been shown that in patients where treatment with anticoagulants could be performed without difficulty, withdrawal of the drug is disadvantageous. Large-scale studies have shown the relatively slight effect of drugs which inhibit platelet aggregation. The indication for these drugs, and "prophylactic" surgery to improve prognosis, are discussed with respect to the various risk groups.