The use of oral anticoagulants in patients with myocardial infarction (MI) has been shown to have beneficial effects in terms of reduction in mortality.
Oral anticoagulants in MI
|Investigators & study design
|International Anticoagulant Review Group54
This was a review of 9 well designed trials involving patients with MI
|2205 male and 282 female patients
||Long-term oral anticoagulant treatment after infarction
- Of the men under the age of 55 years, 91% were alive after 2 years vs. 85% in the control group not receiving the anticoagulant (p<0.01)
- In men over the age of 55 years, 75% were alive at the end of 3 years vs. 69% in the control group (p<0.05).
- The overall reduction in mortality was 20%.
|Sixty Plus Reinfarction Study Research Group55
This was a randomized double-blind multicentre clinical trial.
|878 patients over 60 years of age, who had suffered a MI and were on oral anticoagulant therapy for
||Half of the patients received placebos instead of the anticoagulant; the others continued anticoagulant therapy. All were followed for 2 years.
- 2-year incidence of recurrent MI was 15.9% in the placebo group and 5.7% in the anticoagulant treated group (p=0.0001).
- The incidence of intracranial events was 5.6% in the placebo group and 3.1% in the group on anticoagulants (p=0.18).
- No fatal extracranial hemorrhages were seen.
|Hurtado L et al.56
||300 patients with acute MI
||Group I - anticoagulant treatment with heparin and acenocoumarol
Group II - did not have anticoagulant therapy
- The incidence of persistent angina, arrhythmias, pulmonary embolism and reinfarction was not different for both groups.
- The mortality was slightly higher in group II.
- Of the patients who died, the autopsy demonstrated fresh thrombi in all cases of both groups; in addition, in most of the patients of group II, hemorrhage of the coronary artery wall was found.