Long-Term Use of Anticoagulants in Private Practice

THE EFFICACY of anticoagulants in the treatment of myocardial infarction and in the postinfarction period is controversial.¹However, it appears likely that such therapy will be used for some time. The risks of anticoagulant therapy are relatively small, as determined in many well-controlled studies.² ⁻⁴The most important risk is major hemorrhage, the incidence of which was found to be 1.5% to 10% in both short²,³and long-term⁴,⁵usage. Most of the studies have been done in large medical centers. There have been very few reports from private practice, where the incidence of serious hemorrhage may be different. Pastor et al have suggested⁵that the statistics in well-controlled studies may not reflect the true incidence of hemorrhage or fatality, since the practicing physicians who administer most of the anticoagulants do not have occasion to publish their results. One of the most important factors in determining