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January 20, 2004European Heart Journal

The combination of cardiovascular death, reinfarction or stroke occurred in 28.1% in the aspirin+warfarin group versus 28.8% in the aspirin group (not significant).

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Why the study?

Does fixed low-dose warfarin added to aspirin reduce the composite of cardiovascular death, reinfarction, or stroke in patients hospitalized for acute myocardial infarction?

Population

3,300 patients hospitalized for acute myocardial infarction (AMI) in Sweden.

Comparison

Warfarin 1.25 mg plus aspirin 75 mg daily vs Aspirin 75 mg daily alone

Design

RCT, randomized, Prospective Open Treatment and Blinded End Point Evaluation

Follow-up

median 5.0 years

Authors

JHJohan Herlitz

Discussion

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Overview

No support for adding fixed low-dose warfarin to aspirin post-MI; confirms lack of efficacy on major cardiovascular events.

Structured PICO

Does fixed low-dose warfarin added to aspirin reduce the composite of cardiovascular death, reinfarction, or stroke in patients hospitalized for acute myocardial infarction?

P
Population
3,300 patients hospitalized for acute myocardial infarction (AMI) in Sweden.
I
Intervention
Warfarin 1.25 mg plus aspirin 75 mg daily
C
Comparator
Aspirin 75 mg daily alone
O
Outcome
Composite of cardiovascular death, reinfarction or strokecomposite

Adding a fixed low dose of warfarin to aspirin after an acute myocardial infarction does not reduce cardiovascular events but significantly increases the risk of serious bleeding.

Cite This Study

Johan Herlitz (2004) studied this question.

synapsesocial.com/papers/6a1fde1b10c23ffe0e4306b0https://doi.org/10.1016/j.ehj.2003.10.026
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