Prognosis and Management after a First Myocardial Infarction

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Abstract
PATIENTS who have a first myocardial infarction deserve consideration as a special group. For the most part, the early mortality rate from a first infarction is roughly half the rate found in patients with a second or third infarction,1 , 2 and the long-term survival is considerably better than in patients who have had previous infarctions.3 , 4 The published studies on risk stratification4 5 6 and treatment7 8 9 after an infarction have paid remarkably little attention to patients having their first myocardial infarction. Such patients constitute a majority (60 to 80 percent) of those with acute infarction, yet they are rarely viewed as a special group. . . .