Of the more than 1 million Americans who suffer recognized myocardial infarctions (MIs) annually, about 300,000 die in the first year, and a similar number fall victim to crippling heart failure (HF)(1). Although advances in revascularization and HF therapies have somewhat blunted its devastating impact, this modern-day scourge remains an important clinical challenge. Heart failure following MI can result from the acute loss of myocytes in the infarct zone, but more often is precipitated by the delayed and progressive pathologic remodeling of the ventricle. In this issue of the Journal, Abbate et al.(2) examine the relationship between apoptotic death of cardiac myocytes in the infarcted and noninfarcted regions, and the subsequent development of HF in patients with recent MI.