Prevention

• symptomatic angina pectoris during predischarge exercise test
• ST changes during exercise, compatible with ischaemia

• Performing angiography followed by PTCA or CABG on all patients with post-infarction ischaemia reduces subsequent reinfarction and unstable angina compared with conservative management unless patients have severe angina.  There is no clear effect on mortality. ^a

Invasive therapy following MI reduces reinfarction and unstable angina compared with conservative therapy

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
myocardial infarction a	invasive therapy (arteriography and PTCA or CABG)	medical therapy	unstable angina at 12 months	39%	39% (24% to 52%)	9 (6 to 16)
			reinfarction at 12 months	11%	47% (18% to 66%)	20  (12 to 63)