Björck et al of lipid-lowering drugs in patients with CHD. Yet, how this has inﬂuenced lipid levels in unselected post-AMI patients has not been systematically explored. Therefore, the aim of this single-centre study was to describe among younger men and women with a ﬁrst AMI changes in pharmacological treatment with lipid-lowering drugs between 1994 and 2002, to quantify ensuing changes in mean serum concentrations of cholesterol and triglycer- ides, and to estimate the proportion of patients who meet current European target levels for serum total cholesterol (De Backer et al 2003). Methods Patients for this study were consecutively included among patients discharged from the Coronary Care Unit (CCU) or step-down unit at the Sahlgrenska University Hospital/ Östra, Sweden. The catchment’s area of the Sahlgrenska University Hospital/Östra is the northern and eastern parts of Göteborg, with a population of 250,000. Since 1994, all patients under 65 years of age with a ﬁrst AMI were sched- uled for a structured nurse-led follow-up visit 3 months after discharge. During the period 1994 to 2002, 952 patients were discharged alive from hospital with a discharge diagnosis of a ﬁrst myocardial infarction deﬁned as typical symptoms and either typical ECG changes and/or increased levels of creatin-kinaseMB subunit mass concentration (1994–2001 15 μg/l, from 2002 10 μg/l). Four patients died before they could be investigated, the medical condition of 8 patients precluded the follow-up visit and 16 patients had their visit in another area. One hundred forty-three patients were either not admitted to the coronary care unit and were therefore not scheduled for routine follow-up, or had a late follow-up with no systematic collection of data and were thus excluded. After these exclusions, 781 patients (607 men, 174 women) were available for the present investigation. All patients were rou- tinely offered dietary counseling by nurses and dieticians in group sessions using essentially the same methods throughout the study period. At the 3-month follow-up, anthropometric measurements, including blood samples, were performed and information on previous diabetes, hypertension and smoking were recorded in a standardized protocol. The study protocol was approved by the Ethics committee of Göteborg University. Follow-up visit At follow-up 3 months after the myocardial infarction, blood samples for serum cholesterol and serum triglycerides were drawn after an overnight fast. Use of any lipid-lowering 1046 drug and dosage was recorded, as were data on smoking, diabetes and hypertension. Body weight was measured on a lever balance to the nearest 0.1 kg while the patient was wearing indoor clothing. Height was recorded to the near- est centimetre. Body mass index (BMI, weight in kg/height in m2) was used as an index of relative weight and over- weight/obesity. Deﬁnitions Hypertension was deﬁned as diagnosed by a physician before hospitalization. Diabetes was deﬁned as diagnosed by a physician before or during hospitalization. Data on smoking habits at the time of hospitalization and at the fol- low-up visit were self-reported and/or from hospital records. Total cholesterol concentration and serum triglyceride concentration were measured at the 3-month follow-up or at a later visit (maximum 6 months after the AMI). Blood samples were drawn from an antecubital vein and fasting serum cholesterol and triglyceride measurements were determined according to standard laboratory procedures. Since 1993, serum cholesterol has been analyzed according to Boehringer Mannheim (cat. no. 701912). This method is the standard method of the Laboratory of Clinical Chemistry (certiﬁed laboratory) at Göteborg University and remained constant through the study period. Target levels for total serum cholesterol were deﬁned as 4.5 mmol/l accord- ing to the current European Society of Cardiology (ESC) guidelines (De Backer et al 2003). Statistical methods The SPSS statistical package (version 11.0) was used for all statistical analyses. Background data were divided into three 3-year periods: 1994–1996, 1997–1999, and 2000–2002. The results are shown as means and standard deviations (SD) for serum cholesterol, serum triglycerides and percentage treated with lipid-lowering drugs each 3-year period from 1994–2002. EpiInfo was used for statistical analysis of lin- ear trends over the years 1994–2002. p-values 0.05 were considered signiﬁcant. Results Risk factors at baseline Patient characteristics are shown in Table 1. Mean age for men was 54.0 (SD 7.65) years and for women 55.7 (SD 7.29) years. Fifty-six and 59% of the men and women, respectively, were smokers before their AMI. At follow-up, 24% of the men and 27% of the women were still smoking. One in ﬁve patients had diabetes, with no gender differences. Vascular Health and Risk Management 2007:3(6)