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Previous Volume 347:969-974 September 26, 2002 Number 13 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Becker, R. C. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background The role of antithrombotic therapy in secondary prevention after myocardial infarction is well established. Although the available literature suggests that warfarin is superior to aspirin, aspirin is currently the more widely used drug. We studied the efficacy and safety of warfarin, aspirin, or both after myocardial infarction.

Methods In a randomized, multicenter trial in 3630 patients, 1216 received warfarin (in a dose intended to achieve an international normalized ratio [INR] of 2.8 to 4.2), 1206 received aspirin (160 mg daily), and 1208 received aspirin (75 mg daily) combined with warfarin (in a dose intended to achieve an INR of 2.0 to 2.5). The mean duration of observation was four years.

Results The primary outcome, a composite of death, nonfatal reinfarction, or thromboembolic cerebral stroke, occurred in 241 of 1206 patients receiving aspirin (20.0 percent), 203 of 1216 receiving warfarin (16.7 percent; rate ratio as compared with aspirin, 0.81; 95 percent confidence interval, 0.69 to 0.95; P=0.03), and 181 of 1208 receiving warfarin and aspirin (15.0 percent; rate ratio as compared with aspirin, 0.71; 95 percent confidence interval, 0.60 to 0.83; P=0.001). The difference between the two groups receiving warfarin was not statistically significant. Episodes of major, nonfatal bleeding were observed in 0.62 percent of patients per treatment-year in both groups receiving warfarin and in 0.17 percent of patients receiving aspirin (P<0.001).

Conclusions Warfarin, in combination with aspirin or given alone, was superior to aspirin alone in reducing the incidence of composite events after an acute myocardial infarction but was associated with a higher risk of bleeding.

Source Information

From the Department of Cardiology (M.H., H.A.) and the Research Forum (M.A.), Ullevål University Hospital, Oslo; Bærum Hospital, Bærum (P.S.); and Akershus University Hospital, Akershus (J.E.) — all in Norway.

Address reprint requests to Dr. Hurlen at the Medical Department, Ullevål University Hospital, N-0407 Oslo, Norway.

Full Text of this Article

Related Letters:

Warfarin, Aspirin, or Both after Myocardial Infarction
Pullicino P., Thompson J. L.P., Amit G., Ilia R., Zahger D., Aronow W. S., Hurlen M., Arnesen H., Smith P.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:256-257, Jan 16, 2003. Correspondence

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• The Warfarin Antiplatelet Vascular Evaluation Tria, (2007). Oral Anticoagulant and Antiplatelet Therapy and Peripheral Arterial Disease. NEJM 357: 217-227 [Abstract] [Full Text]  
• Mohler, E. R. III (2007). Atherothrombosis -- Wave Goodbye to Combined Anticoagulation and Antiplatelet Therapy?. NEJM 357: 293-296 [Full Text]  
• Siu, C.-W., Jim, M.-H., Ho, H.-H., Miu, R., Lee, S. W.L., Lau, C.-P., Tse, H.-F. (2007). Transient Atrial Fibrillation Complicating Acute Inferior Myocardial Infarction: Implications for Future Risk of Ischemic Stroke. Chest 132: 44-49 [Abstract] [Full Text]  
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• Witt, B. J., Brown, R. D. Jr., Jacobsen, S. J., Weston, S. A., Yawn, B. P., Roger, V. L. (2005). A Community-Based Study of Stroke Incidence after Myocardial Infarction. ANN INTERN MED 143: 785-792 [Abstract] [Full Text]  
• Kushner, F. G., Antman, E. M. (2005). Oral Anticoagulation for Atrial Fibrillation After ST-Elevation Myocardial Infarction: New Evidence to Guide Clinical Practice. Circulation 112: 3212-3214 [Full Text]  
• Stenestrand, U., Lindback, J., Wallentin, L., for the RIKS-HIA Registry, (2005). Anticoagulation Therapy in Atrial Fibrillation in Combination With Acute Myocardial Infarction Influences Long-Term Outcome: A Prospective Cohort Study From the Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA). Circulation 112: 3225-3231 [Abstract] [Full Text]  
• Rothberg, M. (2005). Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin Alone. ANN INTERN MED 143: 464-464 [Full Text]  
• Rothberg, M. B., Celestin, C., Fiore, L. D., Lawler, E., Cook, J. R. (2005). Warfarin plus Aspirin after Myocardial Infarction or the Acute Coronary Syndrome: Meta-Analysis with Estimates of Risk and Benefit. ANN INTERN MED 143: 241-250 [Abstract] [Full Text]  
• Saseen, J. J. (2005). ASHP Therapeutic Position Statement on the Daily Use of Aspirin for Preventing Cardiovascular Events. Am J Health Syst Pharm 62: 1398-1405 [Full Text]  
• Hart, R. G., Tonarelli, S. B., Pearce, L. A. (2005). Avoiding Central Nervous System Bleeding During Antithrombotic Therapy: Recent Data and Ideas. Stroke 36: 1588-1593 [Abstract] [Full Text]  
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• Hirsh, J., O'Donnell, M., Weitz, J. I. (2005). New anticoagulants. Blood 105: 453-463 [Abstract] [Full Text]  
• Gollapudi, R. R., Teirstein, P. S., Stevenson, D. D., Simon, R. A. (2004). Aspirin Sensitivity: Implications for Patients With Coronary Artery Disease. JAMA 292: 3017-3023 [Abstract] [Full Text]  
• Dager, W. E, Vondracek, T. G, McIntosh, B. A, Nutescu, E. A (2004). Ximelagatran: An Oral Direct Thrombin Inhibitor. The Annals of Pharmacotherapy 38: 1881-1897 [Abstract] [Full Text]  
• Perez-Gomez, F., Alegria, E., Berjon, J., Iriarte, J. A., Zumalde, J., Salvador, A., Mataix, L., NASPEAF Investigators, (2004). Comparative effects of antiplatelet, anticoagulant, or combined therapy in patients with valvular and nonvalvular atrial fibrillation: A randomized multicenter study. J Am Coll Cardiol 44: 1557-1566 [Abstract] [Full Text]  
• Falk, R. H. (2004). Reconsidering combined antiplatelet and anticoagulant therapy in atrial fibrillation. J Am Coll Cardiol 44: 1567-1569 [Full Text]  
• Shireman, T. I., Howard, P. A., Kresowik, T. F., Ellerbeck, E. F. (2004). Combined Anticoagulant-Antiplatelet Use and Major Bleeding Events in Elderly Atrial Fibrillation Patients. Stroke 35: 2362-2367 [Abstract] [Full Text]  
• Kovacs, M.J., Kearon, C., Rodger, M., Anderson, D.R., Turpie, A.G.G., Bates, S.M., Desjardins, L., Douketis, J., Kahn, S.R., Solymoss, S., Wells, P.S. (2004). Single-Arm Study of Bridging Therapy With Low-Molecular-Weight Heparin for Patients at Risk of Arterial Embolism Who Require Temporary Interruption of Warfarin. Circulation 110: 1658-1663 [Abstract] [Full Text]  
• Ansell, J., Hirsh, J., Poller, L., Bussey, H., Jacobson, A., Hylek, E. (2004). The Pharmacology and Management of the Vitamin K Antagonists: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126: 204S-233S [Abstract] [Full Text]  
• Weitz, J. I., Hirsh, J., Samama, M. M. (2004). New Anticoagulant Drugs: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126: 265S-286S [Abstract] [Full Text]  
• Singer, D. E., Albers, G. W., Dalen, J. E., Go, A. S., Halperin, J. L., Manning, W. J. (2004). Antithrombotic Therapy in Atrial Fibrillation: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126: 429S-456S [Abstract] [Full Text]  
• Salem, D. N., Stein, P. D., Al-Ahmad, A., Bussey, H. I., Horstkotte, D., Miller, N., Pauker, S. G. (2004). Antithrombotic Therapy in Valvular Heart Disease--Native and Prosthetic: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126: 457S-482S [Abstract] [Full Text]  
• Earl, M. A., Mauro, V. F. (2004). The Clinical Impact of Administering Warfarin to Post-Myocardial Infarction Patients. Journal of Pharmacy Practice 17: 266-269 [Abstract]  
• Sinnaeve, P R, Van de Werf, F J (2004). Will oral antithrombin agents replace warfarin?. Heart 90: 827-828 [Abstract] [Full Text]  
• Gluckman, T. J., Baranowski, B., Ashen, M. D., Henrikson, C. A., McAllister, M., Braunstein, J. B., Blumenthal, R. S. (2004). A Practical and Evidence-Based Approach to Cardiovascular Disease Risk Reduction. Arch Intern Med 164: 1490-1500 [Abstract] [Full Text]  
• Antman, E. M (2004). The re-emergence of anticoagulation in coronary disease. Eur Heart J Suppl 6: B2-B8 [Abstract] [Full Text]  
• Wallentin, L (2004). Oral direct thrombin inhibition for anticoagulation in coronary artery disease - focus on the ESTEEM trial. Eur Heart J Suppl 6: B9-B14 [Abstract] [Full Text]  
• The AFFIRM Investigators, (2004). Relationships Between Sinus Rhythm, Treatment, and Survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study. Circulation 109: 1509-1513 [Abstract] [Full Text]  
• O'Donnell, M., Hirsh, J. (2004). Establishing an Optimal Therapeutic Range for Coumarins: Filling in the Gaps. Arch Intern Med 164: 588-590 [Full Text]  
• van der Elst, M. E, Buurma, H., Bouvy, M. L, de Boer, A. (2003). Drug Therapy for Prevention of Recurrent Myocardial Infarction. The Annals of Pharmacotherapy 37: 1465-1477 [Abstract] [Full Text]  
• Jeddy, A. S, Gleason, B. L (2003). Aspirin and Warfarin Versus Aspirin Monotherapy After Myocardial Infarction. The Annals of Pharmacotherapy 37: 1502-1505 [Abstract] [Full Text]  
• Schulman, S. (2003). Care of Patients Receiving Long-Term Anticoagulant Therapy. NEJM 349: 675-683 [Full Text]  
• Dager, W. E (2003). Initiating Warfarin Therapy. The Annals of Pharmacotherapy 37: 905-908 [Full Text]  
• Wallentin, L., Bergstrand, L., Dellborg, M., Fellenius, C., Granger, C. B, Lindahl, B., Lins, L.-E., Nilsson, T., Pehrsson, K., Siegbahn, A., Swahn, E., for the ASSENT PLUS Investigators, (2003). Low molecular weight heparin (dalteparin) compared to unfractionated heparin as an adjunct to rt-PA (alteplase) for improvement of coronary artery patency in acute myocardial infarction--the ASSENT Plus study. Eur Heart J 24: 897-908 [Abstract] [Full Text]  
• (2003). OTHER ARTICLES NOTED (25 Oct 02 to 17 Jan 03). Evid. Based Nurs. 6: e1-7 [Full Text]  
• Fadl, Y. Y., Zareba, W., Moss, A. J., Marder, V. J., Sparks, C. S., Miller Watelet, L. F., Carroll, E. R. (2003). History of Hypertension and Enhanced Thrombogenic Activity in Postinfarction Patients. Hypertension 41: 943-949 [Abstract] [Full Text]  
• Topol, E. J, Hurlen, M, Arnesen, H (2003). Warfarin alone or with aspirin was superior to aspirin alone after acute myocardial infarction but increased bleeding. Evid. Based Med. 8: 42-42 [Full Text]  
• Pullicino, P., Thompson, J. L.P., Amit, G., Ilia, R., Zahger, D., Aronow, W. S., Hurlen, M., Arnesen, H., Smith, P. (2003). Warfarin, Aspirin, or Both after Myocardial Infarction. NEJM 348: 256-257 [Full Text]  
• The Task Force on the Management of Acute Myocardi, , Van de Werf, F., Ardissino, D., Betriu, A., Cokkinos, D. V., Falk, E., Fox, K. A.A., Julian, D., Lengyel, M., Neumann, F.-J., Ruzyllo, W., Thygesen, C., Underwood, S. R., Vahanian, A., Verheugt, F. W.A., Wijns, W. (2003). Management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 24: 28-66 [Full Text]  
• Hudson, M. P (2003). Coumadin alone or aspirin plus coumadin reduced coronary events and death after acute myocardial infarction or unstable angina. Evid. Based Med. 8: 16-16 [Full Text]  
• Malik, I. (2002). JournalScan. Heart 88: 671-672 [Full Text]  
• (2002). More Data for the Post-MI Warfarin vs. Aspirin Debate. Journal Watch Cardiology 2002: 1-1 [Full Text]