Warfarin, Aspirin, or Both after Myocardial Infarction

Hurlen, Mette; Abdelnoor, Michael; Smith, Pål; Erikssen, Jan; Arnesen, Harald

doi:10.1056/nejmoa020496

Cited by 752 publications

(202 citation statements)

References 27 publications

Supporting

Mentioning

183

Contrasting

Unclassified

Order By: Relevance

“…Warfarin alone or in combination with aspirin was superior to aspirin alone regarding endpoints, but it increased the risk of major, nonfatal bleeding after MI (Hurlen, Abdelnoor, Smith, Erikssen, & Arnesen, 2002). In fact, the long‐term effects of administering AC/APT after TIA/stroke due to arteriosclerotic disease for the remainder of the patient′s life remains unknown (Cleland, 2006).…”

Section: Introductionmentioning

confidence: 99%

Secondary prophylactic treatment and long‐term prognosis after TIA and different subtypes of stroke. A 25‐year follow‐up hospital‐based observational study

Eriksson

2016

Brain and Behavior

View full text Add to dashboard Cite

ObjectivesTo assess long‐term prognosis after transient ischemic attack (TIA)/subtypes of stroke relative to secondary prophylactic treatment(s) given.Materials and MethodsRetro/prospective follow‐up of patients hospitalized in the Stroke Unit or in the Department of Neurology, Linköping, in 1986 and followed up to Feb. 2011.ResultsA total of 288 men were followed up for 2254 years (mean 7.8 years) and 261 women for 1984 years (mean 7.6 years). In men, the distribution to anticoagulants (AC) (warfarin treatment) was 18%, antiplatelet therapy (APT) usually ASA 75 mg/day 54%, untreated 27%, unknown 2%. In women, the distribution to AC was 15%, APT 60%, untreated 23%, unknown 2%, respectively. Mortality rates at 1 year, 10 years, and 25 years for men were 21%, 67%, and 93%, respectively, versus the rates in women of 24%, 71%, and 90%, respectively. Survival curves showed markedly increased risk of death compared to the normal population. AC treatment was more favorable for men regarding the annual risk of stroke, compared with APT (9.4% vs. 9.8%), as well as the risks of MI, (5.6% vs. 6.7%), and death (8.1% vs. 10.3%), compared to women for stroke (11.6% vs. 8.8%) and MI (5.3% vs. 3.7%) but not for death (8.3% vs. 8.4%). The risk of fatal bleeding was 0.86% annually on AC compared to 0.17% on APT. According to Cox regression analysis included patients with TIA/ischemic stroke, first‐line treatment had beneficial effects on survival: AC OR 0.67 (0.5–0.9), APT 0.67 (0.52–0.88) versus untreated.ConclusionsPatients with a history of TIA/stroke had a higher mortality rate versus controls, providing support for both primary and secondary prophylaxis regarding vascular risk factors for death. This study also provided support for secondary prophylactic treatment with either AC or ASA (75 mg once daily) to reduce the vascular risk of death unless there are contraindications.

show abstract

Section: Introductionmentioning

confidence: 99%

Secondary prophylactic treatment and long‐term prognosis after TIA and different subtypes of stroke. A 25‐year follow‐up hospital‐based observational study

Eriksson

2016

Brain and Behavior

View full text Add to dashboard Cite

show abstract

“…3,4 Both its safety profile and the need for a dose-adjustment were factors that limited widespread implementation. Now that nonvitamin K oral anticoagulants have been introduced with superior safety profiles to vitamin K antagonists, we also welcome the new initiatives to use oral anticoagulation with and without aspirin.…”

Section: To the Editormentioning

confidence: 99%

Letter by Damen et al Regarding Article, “A Critical Appraisal of Aspirin in Secondary Prevention: Is Less More?”

Damen¹,

Brouwer²,

Verheugt³

2017

Circulation

View full text Add to dashboard Cite

“…That thrombin plays a role here is strongly suggested by the observation that oral anticoagulation as well as heparin have a preventive action on the reoccurrence of myocardial reinfarction,6, 7 all the more as the effect superimposes on that of aspirin8; nevertheless, the role of thrombin remains rather equivocal. While straightforward risk associations between thrombin generation and thrombosis have been published, also by us, several other studies show inverse relationships (to be discussed below).…”

Section: Introductionmentioning

confidence: 99%

Thrombin Generation and Atherothrombosis: What Does the Evidence Indicate?

Cate

Hemker

2016

JAHA

View full text Add to dashboard Cite

Warfarin, Aspirin, or Both after Myocardial Infarction

Abstract: Warfarin, in combination with aspirin or given alone, was superior to aspirin alone in reducing the incidence of composite events after an acute myocardial infarction but was associated with a higher risk of bleeding.

Cited by 752 publications

References 27 publications

Secondary prophylactic treatment and long‐term prognosis after TIA and different subtypes of stroke. A 25‐year follow‐up hospital‐based observational study

Secondary prophylactic treatment and long‐term prognosis after TIA and different subtypes of stroke. A 25‐year follow‐up hospital‐based observational study

Letter by Damen et al Regarding Article, “A Critical Appraisal of Aspirin in Secondary Prevention: Is Less More?”

Thrombin Generation and Atherothrombosis: What Does the Evidence Indicate?

Contact Info

Product

Resources

About