PMID: 4885307Feb 8, 1969Paper

Assessment of short-anticoagulant administration after cardiac infarction. Report of the Working Party on Anticoagulant Therapy in Coronary Thrombosis to the Medical Research Council

British Medical Journal

Abstract

This report describes the design and results of a controlled trial of anticoagulant drugs in the treatment of patients admitted to hospital suffering from acute myocardial infarction. A total of 1,427 patients were allocated at random to therapy with high-dosage or low-dosage anticoagulants. The high-dosage regimen was 36 hours of heparin administration and phenindione in doses to maintain the thrombotest level between 10 and 20%. The mean phenindione dosage was 72 mg./day. The low-dosage regimen consisted of 1-mg. tablets of phenindione. Therapy was continued for 28 days.There was no significant reduction in the mortality in the high-dosage group. Among the 712 patients allocated to high dosage 115 (16.2%) died before the 29th day of the trial. Of the 715 patients allocated to low dosage 129 (18%) died. This difference between these mortality rates could have occurred by chance.There was a significant reduction in the frequency of clinically evident thromboembolic complications (systemic artery occlusion, leg vein thrombosis, and pulmonary embolism) among patients in the high-dosage group. This did not, however, materially affect the difference in mortality from all causes.

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