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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 June 30; 334(7608): 1336.
PMCID: PMC1906632
What about the GPs?

We help treat acute coronary syndromes

Hasnain M Dalal, general practitioner

I was disappointed that the role of primary care and cardiac rehabilitation in the long term treatment of patients with acute coronary syndromes was not acknowledged by Peters et al.1 A similar review in the Lancet made the same omission.2 The importance of cardiac rehabilitation after myocardial infarction has recently been emphasised by guidance from the National Institute for Health and Clinical Excellence.3 The evidence for the effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care4 has been included in the quality and outcomes framework of the new general practitioner contract. When such primary care based clinics are integrated with cardiac rehabilitation programmes, optimal longterm treatment is possible for patients with acute coronary syndromes.5


Competing interests: None declared.


1. Peters RJ, Mehta S, Yusuf S. Acute coronary syndromes without ST segment elevation. BMJ 2007;334:1265-9. (16 June.) [PMC free article] [PubMed]
2. Boersma E, Mercado N, Poldermans D, Gardien M, Vos J, Simoons ML. Acute myocardial infarction. Lancet 2003;361:847-58. [PubMed]
3. Skinner JS, Cooper A, Feder GS. Secondary prevention for patients after a myocardial infarction: summary of NICE guidance. BMJ 2007;334:1112-3. (26 May.) [PMC free article] [PubMed]
4. Campbell NC, Thain J, Deans HG, Ritchie LD, Rawles JM, Squair JL. Secondary prevention clinics for coronary heart disease: randomised trial of effect on health. BMJ 1998;316:1434-7. [PMC free article] [PubMed]
5. Dalal HM, Evans PH. Achieving national service framework standards for cardiac rehabilitation and secondary prevention. BMJ 2003;326:481-4. [PMC free article] [PubMed]

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