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Despite advances in both the early management and longer-term treatment of acute myocardial infarction, this condition still represents a leading cause of morbidity and mortality in western countries, making essential understanding its determinants. All epidemiologic studies examining prognosis after acute myocardial infarction have used data collected in the midst of the epidemic, possibly giving rise to conflicting results. Hospitalization rates for myocardial infarction have remained relatively stable for the past five decades, in the face of declining coronary heart disease risk factor prevalence and mortality rates, yielding to a paradoxical effect. Many factors like the decrease in severity of such disease and the changes in myocardial infarction definitions may have contributed to such phenomenon. Moreover, because non-ST elevation myocardial infarctions now constitute most of cases in communities, interventions must be designed that recognize this epidemiological reality. At the same time, improved survival in recent decades may have contributed to an increase in the pool of people at risk for developing HF. Thus, the epidemiology and treatment of this condition has not stood still., (Copyright © 2010 Mosby, Inc. All rights reserved.)