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To the Editor.—
I wish to comment on the editorial, "The Case for Anticoagulants in Acute Myocardial Infarction: How Do You Know You Cannot Do It Better?" by Modan et al, which appeared in the November 1976 Archives (136:1230-1231). The authors "suspect" that the anticoagulants, in addition to reducing blood viscosity, also produce other pharmacological effects that might contribute to the favorable results of these substances in the treatment of acute myocardial infarction.There actually already exist numerous observations on the manifold "extra-anticoagulant" side effects of these drugs, ie, those pharmacodynamic properties that are not related to their specific anticlotting activity, including the following information:
Oral anticoagulants have an effect on myocardial contractility, oxygen consumption, adrenergic myocardial necroses, platelet adhesiveness, capillary permeability, uricemia, and inflammatory reactions. Some of these pharmacodynamic properties are abolished by simultaneously administered vitamin K; others are not. The different oral anticoagulants—in the coumarin group, as
Eichbaum FW. Treatment With Anticoagulants and Heparin. Arch Intern Med. 1978;138(3):496. doi:10.1001/archinte.1978.03630270100036