Improvements in the treatment of acute myocardial infarc-tion (AMI), especially use of reperfusion therapy, have led to larger numbers of survivors. In patients who would have survived despite reperfusion therapy, use of this treatment should lead to greater myocardial salvage and a reduced extent of ventricular injury in many. However, others who might not have survived previously may now do so, but with substantial left ventricular damage. 1, 2 The net consequence of these 2 opposing effects on the early and later risk of developing heart failure after AMI is uncertain. There has been concern, however, that an increasing pool of survivors of AMI might fuel an “epidemic” of heart failure.