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September 1, 1962

Anticoagulant Therapy in Acute Myocardial Infarction

Author Affiliations

Milford Memorial Hospital, Inc., Milford, Del.

JAMA. 1962;181(9):804-805. doi:10.1001/jama.1962.03050350066022

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To the Editor:—  Dr. Charles K. Friedberg's article on abandoning anticoagulants in myocardial infarction (JAMA180:307 [April 28] 1962) is an incomplete analysis of the problem.Dr. Friedberg continually speaks of the reduction in thromboembolism and ignores myocardial rupture, intimal hemorrhage, renal hemorrhage, and cerebral hemorrhage. Simply because a mode of treatment has a favorable influence on the process treated does not make the treatment practicable or desirable. For instance, bilateral pyelonephritis could be 100% "cured" by bilateral nephrectomy.Dr. Friedberg points out that 100 series favor anticoagulation and only a "half-dozen" are against, as if scientific proof were a matter of democracy.In analyzing the Danish series he states, "Furthermore, the disproportionately low incidence of thromboembolism in the treated as compared with that in the untreated, fatal cases, indicates a much higher incidence of other serious complications in the treated cases, which casts doubt on the claims the

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