RISK STRATIFICATION AFTER MYOCARDIAL-INFARCTION IN SCOTLAND

The objective was to determine how patients are selected for invasive investigation after myocardial infarction in Scotland. Cardiologists i n Scotland were surveyed by postal questionnaire asking them to detail their approach to four sample clinical scenarios. Complete responses were obtained from 82% of those surveyed Substantial differences in pr actice were observed in the management of subjects with non-e wave myo cardial infarction. Of the cardiologists surveyed 40% would undertake coronary angiography irrespective of the results of non-invasive testi ng in a 45 year old patient, but only one would adopt the same policy in an otherwise fit 77 year old. Only 44% would perform any investigat ions' (beyond echocardiography) in the 77 year old. A minority of resp ondents felt that their practice was influenced by resource limitation . Considerable variation continues to exist in the approach to risk st ratification after myocardial infarction for some groups of patients. This variation may occur principally as a consequence of physician pre ference.