Abstract : Patients after a myocardial infarction are at increased risk of adverse cardiovascular outcomes. They require aggressive secondary preventive measures to control cardiovascular risk factors, and prescription of some pharmacological agents. Compelling data derived from randomized controlled trials have shown the benefits of aspirin (or clopidogrel), statins, beta-blockers and angiotensin-converting enzyme inhibitors, in preventing recurrent events and improving survival. In some cases oral anticoagulants or fibrates may be necessary. Other agents as antioxidant vitamins, folate and B vitamins are disappointing. Lifestyle and dietary modifications can also have an important beneficial effect on mortality rates and should never be neglected.