Long-Term Anticoagulant Therapy After Acute Myocardial Infarction

The unpredictable nature of the clinical illness caused by coronary atherosclerosis makes evaluation of the therapy of this disorder very difficult. Since the time interval between the onset of symptoms and death may vary from a few seconds to over 20 years, it is impossible to draw definite conclusions about the effect of treatment unless large groups of patients are studied. While the value of anticoagulant administration during the first few weeks after an acute myocardial infarction has been amply demonstrated,1-3there is lack of agreement as to the indications for continuing and ultimately for discontinuing long-term anticoagulant therapy after recovery. Because of the tremendous investment in time, money, and effort required of the patient, the doctor, and the laboratory for the successful prosecution of long-term anticoagulant therapy, any contribution toward our appreciation of its benefits and limitations is worthwhile. Because of the frequency of this disease, even a