Key result
Oral anticoagulation at INR 3.0-4.0 cuts post-MI bleeding and thromboembolic events by ~60%.
Why the study?
Oral anticoagulant therapy carries a delicate balance between bleeding and thromboembolic risk, and the optimal intensity to prevent either event after myocardial infarction is unknown.
What is the optimal intensity of oral anticoagulant therapy to minimize the combined risk of bleeding and thromboembolic complications in patients after myocardial infarction?
RCT (n=3,404)
Double-blind
Randomized
Yes
What is the optimal intensity of oral anticoagulant therapy to minimize the combined risk of bleeding and thromboembolic complications in patients after myocardial infarction?
Absolute Event Rate: 3.2% vs 8%
The optimal intensity of long-term oral anticoagulant therapy for post-myocardial infarction patients lies between an INR of 2.0 and 4.0 to balance hemorrhagic and thromboembolic risks.
No takes yet. Share an insight, caveat, or question.
Supports INR 2-4 targeting to minimize combined risks post-MI; hypothesis-generating pending randomized trials.
Azar et al. (1996) conducted an RCT in Myocardial infarction (n=3,404). Oral anticoagulant therapy vs. Placebo was evaluated on Combined outcome of bleeding or thromboembolic complications. Oral anticoagulant therapy achieved the lowest combined incidence of bleeding and thromboembolic complications at an international normalized ratio between 3.0 and 4.0 in patients after myocardial infarction.