The Clock Is Ticking: The Imminent Need to Re-evaluate the Standard of Care in the 90-Day High-Risk Post-Acute Myocardial Infarction Period

Abstract

This CSL Behring-supported symposium took place during the European Society of Cardiology (ESC) 2021 Congress. Experts P. Gabriel Steg Cardiology Department, Hôpital Bichat-Claude-Bernard, Paris, France, and the Université de Paris, France; and Kausik Ray, Imperial Centre for Cardiovascular Disease Prevention, Imperial College London, UK; Imperial Clinical Trials Unit, Imperial College London, UK; and Commercial Trials, Imperial College London, UK, discussed the clinical significance of the early post-acute myocardial infarction (AMI) period and the risk of recurrent events despite optimal recommended standard of care. Steg highlighted data from a retrospective registry study as well as several randomised controlled trials, suggesting that recurrent cardiovascular (CV) events appeared to accrue quickly in the early post-AMI period. He proposed that this may be an important timeframe for additional therapeutic interventions and warrants further investigation. Ray highlighted guideline recommendations for secondary prevention, currently focused on lipid-lowering and antiplatelet therapies. Ray presented data from several randomised controlled trials of lipid-lowering therapies, demonstrating that despite therapeutic advances and guideline-recommended treatments, there is a residual risk of recurrent CV events post-AMI. Ray suggested that additional therapeutic targets should be explored to further reduce the incidence of recurrent CV events post-AMI.