Zullo AR, et al. - A retrospective cohort study is done to assess the new usage of secondary prevention medications after acute myocardial infarction (AMI) in nursing home (NH) residents who were previously nonusers and to evaluate what factors were related to utilization. More than 33% of older NH residents in the United States do not have any secondary prevention medications initiated after AMI, with fewer medications initiated in older residents; women; and those with, DNR orders, poor physical function, and cognitive impairment. A lack of proof about the safety and efficacy of secondary preventions medications in the NH population and unmeasured person-centered goals of care are plausible clarifications for these outcomes.