Introduction
In 1988 the ISIS-2 (Second International Study of Infarct Survival) study brought about a sea change in the management of the patient suffering a myocardial infarction (MI) and, in particular, those who had ST-elevation (STEMI) changes on their electrocardiogram (ECG).1 Prior to that landmark trial, general practitioners (GPs) were much more involved in the care of patients suffering MIs. They had to decide with what urgency the patient had to be admitted, or even if they would be admitted at all, in the light of how little could be done for the patient in hospital. The care provided has improved since then to the point that the