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April 19, 1973New England Journal of Medicine

Prophylactic Anticoagulant Therapy in the Prevention of Calf-Vein Thrombosis after Myocardial Infarction

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Why the study?

Does prophylactic administration of heparin and warfarin reduce calf-vein thrombosis in patients with acute myocardial infarction?

Population

92 consecutive patients with acute myocardial infarction, all receiving active physiotherapy from admission…

Comparison

Prophylactic administration of heparin and… vs No anticoagulation (nonanticoagulated patients).

Design

Cohort

Authors

RWRichard WrayCancer Research UK Cambridge CenterBMB. MaurerSt Michael’s HospitalJSJohn ShillingfordUniversity of London

Discussion

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Implication

Associated with fewer calf-vein thromboses after acute MI; leaves open whether routine prophylaxis is warranted beyond high-risk patients.

Key Points

  • To determine whether prophylactic anticoagulation with heparin and warfarin prevents calf-vein thrombosis in patients recovering from acute myocardial infarction.
  • Controlled study of 92 consecutive patients admitted with acute myocardial infarction.
  • Patients received prophylactic heparin and warfarin versus no anticoagulation, alongside active physiotherapy and mobilization within 7 days.
  • Calf-vein thrombosis surveillance was conducted using the 125I-labeled fibrinogen technique.
  • Calf-vein thrombosis occurred in 6.5% of anticoagulated patients compared to 22% of nonanticoagulated controls.
  • Clinically important pulmonary emboli did not occur in either anticoagulated or nonanticoagulated patients.

Structured PICO

Does prophylactic administration of heparin and warfarin reduce calf-vein thrombosis in patients with acute myocardial infarction?

P
Population
92 consecutive patients with acute myocardial infarction, all receiving active physiotherapy from admission and mobilized within seven days.
I
Intervention
Prophylactic administration of heparin and warfarin.
C
Comparator
No anticoagulation (nonanticoagulated patients).
O
Outcome
Rate of calf-vein thrombosis detected by the 125I fibrinogen technic.hard clinical

Prophylactic anticoagulation reduces calf-vein thrombosis after acute MI, but may be reserved for high-risk or bed-bound patients when early mobilization is utilized.

Cite This Study

Wray et al. (1973) studied this question.

synapsesocial.com/papers/6a922c2cfd48e269e6b87f39https://doi.org/10.1056/nejm197304192881604

Topics

Anticoagulation in AF
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Heparin in the Prevention of Deep Vein Thrombosis after Myocardial Infarction1972 · 106 citations
  2. 2Myocardial Infarction and Deep-vein Thrombosis1971 · 116 citations
  3. 3125I-labelled fibrinogen in the diagnosis of deep-vein thrombosis and its correlation with phlebography1968 · 309 citations
  4. 4Venous Thrombosis and Pulmonary Embolism1948 · 357 citations
  5. 5Prevention of Deep Vein Thrombosis by Intermittent Pneumatic Compression of Calf1972 · 230 citations