Acute Myocardial Infarction 1. It is strongly recommended that all patients with acute myocardial infarction receive a minimum of low-dose heparin, 5,000 IV/SC every 12 hrs, until fully ambulatory to prevent venous thromboembolism. This grade A recommendation is based on the results of one level I study. 2. It is strongly recommended that patients with […]
Most studies of the use of oral anticoagulants in patients with coronary artery disease have been performed in patients with acute myocardial infarction or in survivors of acute myocardial infarction. There have been no appropriately designed trials of anticoagulants in patients with chronic stable angina and only a very limited number of trials for anticoagulants […]
Three studies have assessed the efficacy of low-dose heparin following myocardial infarction. In 1978, Marks and leather reported the results of a study in which 81 postinfarction patients were randomized to receive low-dose heparin (7,500 units subcutaneously bid) or to serve as a control group (level I). Thrombi (detected by leg scanning) occurred in 14 […]
The theoretical rationale for the early use of anticoagulants in patients with acute myocardial infarction is: 1. to prevent extension of coronary artery thrombosis with the expectation that this might reduce mortality by limiting infarction size and prevent reinfarction; 2. to prevent systemic emboli that arise from mural thrombi, a frequent complication in patients with […]
Few subjects have engendered as much controversy as the use of anticoagulants in acute myocardial infarction. Anticoagulant therapy was accepted enthusiastically in the treatment of acute myocardial infarction after the first large clinical trial report was published in 1948. This enthusiasm persisted for approximately two decades, during which it would have been considered unethical not […]
Each year in the United States alone there are about 1 million “heart attacks”—a term that includes both acute infarction and sudden cardiac death. Nearly 300,000 victims die before admission to the hospital, and about another 200,000 die in the first month, most of them in the first 24 hours after the attack. Thus, the […]
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