ESC consensus statement on secondary prevention post-MI "In-hospital prevention should be given as high a priority as initial acute care" The European Society of Cardiology (ESC) has released a consensus document on secondary prevention strategies following an acute myocardial infarction (AMI), which outlines the components of secondary prevention in post-AMI patients for both patients and healthcare providers including healthcare systems to prevent secondary events. The consensus statement is published online September 6, 2016 in the European Journal of Preventive Cardiology. The documents also notes that while acute events are due to ruptured coronary plaques and associated thrombosis, most secondary events are due to the progression of the atherosclerotic process. Hence, secondary prevention becomes important to prevent recurrence, improve functional capacity and quality of life. The ESC emphasizes on a healthy lifestyle as the most effective way to prevent a recurrent heart attack, along with preventive medications and follow up. Risk factors should be identified and managed. Healthy diet, physical activity, weight control, cessation of smoking and stopping alcohol abuse are components of risk factor modification or lifestyle intervention. In-hospital or acute intervention is the earliest intervention, beginning immediately after the acute event during the hospital stay, and it should be given as high a priority as initial acute care. When the patient is discharged, a clear follow-up plan should be formulated. It is important to evaluate that the patient understands his or her diagnosis including instructions about the prescribed medications and lifestyle interventions. The statement advises healthcare providers to “Agree” rather than “dictate” a drug regimen and tailor it to personal lifestyle and needs of the individual patient to improve adherence. The Statement also addresses issues such as comorbidities, psychosocial and economic factors, patient and family education and multidisciplinary follow up, all of which influence outcomes.