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EAPC Opti(MI)se programme

Optimal Therapy after Myocardial Infarction – a programme led by the European Association of Preventive Cardiology

The challenge

Ischaemic heart disease (IHD) affects around 126 million individuals yearly (1.72% of the world’s population) causing nine million deaths globally (1). In Europe, IHD is responsible for 1.7 million deaths per year (2). Acute myocardial infarction (AMI) is often the first manifestation of IHD (3) and is associated with a mortality rate of about 30%, with 50% of deaths occurring prior to arrival at the hospital. At least 5%-10% of survivors die within the first 12 months after the MI, and approximately half of the patients need hospitalisation within a year’s follow-up. Prognosis is highly variable and largely depends on early reperfusion (4).

Importantly, outcomes of AMI vary between and within countries (5). While guidelines show a consensus on optimal treatment strategy, the practical application remains incomplete and therefore treatment goals are insufficiently achieved. The high variability of disease-adjusted life years (DALYs) for CVD and stroke among European countries could be resolved by a new strategy focusing on the uniform implementation of current guidelines by education and dissemination.

The programme

The European Association of Preventive Cardiology (EAPC) is conducting a comprehensive programme to design an optimal post-MI pathway for patients’ follow-up and treatment and improve long-term care in secondary prevention.

  • Project definition and gaps analysis: Assessment of the current management of post-MI patients in different regions in Europe (online survey, workshops with key national stakeholders).
  • Development of Post-MI roadmap and scientific output including the following documents:
    • Systematic review paper on the feasibility and effectiveness of introducing digital technology
    • Quality Indicators manuscript on chronic/long-term follow-up and lifelong treatment post-MI
    • Consensus document reviewing existing situations (best practices, gaps) and outlining a clear process for the optimal detection and management of high / very high-risk patients post-MI
    • ESC/EAPC Clinical Statement on the optimal lifelong pathway post-MI
  • Implementation and evaluation: dissemination of resources, roadmap translation for broader implementation, qualitative and quantitative evaluation of the roadmap’s impact in selected countries.

Steering committee

Davos-Costas-2022.JPGConstantinos Davos
Project lead

Pedretti-Roberto-2021.jpgRoberto  Pedretti
Project Co-lead

van craenenbroeck_emeline-2015.jpgEmeline van Craenenbroeck

Vassilis-Vassiliou-2022.jpegVassilios Vassiliou

Donata Kurpas.jpgDonata Kurpas

This multidisciplinary programme involves experts in the field of primary care, acute cardiovascular care, secondary prevention and rehabilitation, cardiovascular nursing, digital health and patients to ensure a multi-disciplinary approach.


1. Khan MA, Hashim MJ, Mustafa H, Baniyas MY, Al Suwaidi S, AlKatheeri R, et al. Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus. 2020;12(7): e9349.

2. Timmis A, Townsend N, Gale C, Grobbee R, Maniadakis N, Flather M, et al. European Society of Cardiology: Cardiovascular Disease Statistics 2017. Eur Heart J. 2018;39(7):508-79.

3. Thygesen K. 'Ten Commandments' for the Fourth Universal Definition of Myocardial Infarction 2018. Eur Heart J. 2019;40(3):226.

4. Rossello X, Masso-van Roessel A, Perello-Bordoy A, Mas-Llado C, Ramis-Barcelo MF, Vives-Borras M, et al. Assessment of the ESC quality indicators in patients with acute myocardial infarction: a systematic review. Eur Heart J Acute Cardiovasc Care. 2021.

5. Alabas OA, Jernberg T, Pujades-Rodriguez M, Rutherford MJ, West RM, Hall M, et al. Statistics on mortality following acute myocardial infarction in 842 897 Europeans. Cardiovascular research. 2020;116(1):149-57.