The Failure of Anticoagulant Therapy to Prevent Myocardial Infarction in Patients With Premonitory Symptoms of an Impending Coronary Occlusion

T H E advent of the anticoagulants in the treatment of coronary occlusion was received with almost universal enthusiasm when the reports of Nichol, Wright and Peters appeared in the medical literature.1"8 However, the intervening years have somewhat modified in the minds of many physicians the original acceptance of the value of anticoagulants, and reports have appeared which raise some doubt as to their usefulness in this condition.9"15 Nevertheless, many leaders in the field of anticoagulant therapy still retain their original faith in these drugs, and they have implied that the use of anticoagulants in patients with impending coronary occlusion or with recurrent coronary thrombosis might forestall these events. The reports which have appeared on the long-term use of the anticoagulants in the pre-vention of recurrent coronary occlusion have shown a statistical improve-ment in the mortality rate of the treated groups as compared to the non-treated or control groups.16"24 However, Nichol wrote in 1950: "No conclusions are drawn from this