Indications for Bishydroxycoumarin (Dicumarol) in Acute Myocardial Infarction

Many physicians find it difficult to decide whether or not a patient sustaining a mild episode of acute myocardial infarction should be treated with anticoagulant drugs. The Committee for the Evaluation of Anticoagulants in the Treatment of Coronary Occlusion with Myocardial Infarction (American Heart Association) has recommended the employment of such therapy in patients with this disease, unless contraindications to anticoagulant therapy exist. Data are presented to show that in "good risk" patients treated conservatively without anticoagulants, the mortality rate and incidence of thromboembolism are strikingly low. Consequently, even the maximum benefit theoretically obtainable from the employment of dicumarol in these cases is not sufficient to justify the hazard entailed in its use. It is therefore recommended that anticoagulants be employed only in the more serious attacks of the disease.