OBJECTIVES: The objectives of this audit are: (1) to determine the percentage of patients who are discharged on secondary prevention medication following acute myocardial infarction (AMI) including: aspirin, clopidogrel, ACE inhibitors (ACEi), β-blockers (BB), and statins; (2) to identify what dose each patient is discharged on regarding ACEi and BB and when they are initiated; (3) to explore the relationship between blood pressure and ACEi dose titration; (4) to explore the relationship between heart rate and BB dose titration. METHODS: A prospective audit was carried out at the London Chest Hospital (LCH) from June 15-June 28, 2009. All patients who were admitted to the coronary care unit (CCU) with a final diagnosis of AMI were included.  Patients were excluded if they died prior to hospital discharge.  Patients’ demographics, vital signs, drug history, past medical history, drugs during hospital stay and at discharge were collected. RESULTS: 33 patients were included in this audit (mean age 59.7 ± 12.7 years, 79% males, 21% females) with an average length of stay of 2.2 days. 88% of the patients were started ACEi and BB on day 2 of hospitalization. For patients receiving ACEi and BB only 41% were titrated towards the optimal dose. 78% of the opportunities to titrate ACEi according to blood pressure and 55% of the opportunities to titrate BB according to heart rate were not taken. At discharge, 100% were prescribed aspirin, statins, and BB; while 97% were prescribed ACEi and clopidogrel. CONCLUSIONS: This audit reveals high use of secondary prevention medication at the LCH following AMI.  Although there are opportunities for further dose titration prior to discharge, further work is required to establish reasons for missing these opportunities.