Anticoagulants in coronary artery disease

The use of anticoagulants to reduce thromboembolic complications following myocardial infarction and to prevent coronary thrombosis in patients with angina is the subject of sharp controversy. Many eminent clinicians are convinced that anticoagulant therapy during the six weeks or so of the acute phase of infarction saves many lives by reducing the risk of venous and mural thrombosis, embolism and new myocardial infarctions; some of them believe that mortality from coronary artery disease can be further reduced by giving anticoagulants for life after infarction or in patients with severe angina. Some favour anticoagulant therapy only in “high risk” patients, that is, those with severe infarction, heart failure or serious arrhythmias. Other clinicians, equally eminent, find no justification for the routine use of anticoagulants during either the acute phase of myocardial infarction or subsequently.