Oral anticoagulant therapy was associated with a significantly lower fatality rate than no treatment, though maintaining optimum prothrombin levels (10-25%) provided no additional survival advantage.
Cohort (n=761)
Does oral anticoagulant therapy or heparin reduce fatality rates and thromboembolism in patients with acute myocardial infarction?
Oral anticoagulation reduces fatality in acute MI compared to no treatment, but strict prothrombin control offers no additional benefit over poorer control, and heparin alone appears ineffective.
The records of 761 patients with acute myocardial infarction were reviewed to assess the value of optimum anticoagulant therapy and specifically to ascertain the relationship between levels of prothrombin control and fatalities. Results showed that oral anticoagulant therapy was associated with a significantly lower fatality rate than was no treatment; however, there was no relationship between levels of therapy and fatalities. Patients maintained at levels of 10% to 25% of normal prothrombin activity had the same incidence of thromboembolism and death as did those with poorer control and no advantage could be found for optimum therapy as it is now defined. Patients treated solely with heparin throughout hospitalization were considered separately. In this group the incidence of thromboembolism and death was high, resembling the rates obtained without anticoagulation and creating suspicion that heparin is not valuable in acute infarctions.
Meltzer et al. (Sat,) conducted a cohort in Acute myocardial infarction (n=761). Oral anticoagulant therapy vs. No treatment or poorer prothrombin control was evaluated on Fatality rate and incidence of thromboembolism. Oral anticoagulant therapy was associated with a significantly lower fatality rate than no treatment, though maintaining optimum prothrombin levels (10-25%) provided no additional survival advantage.