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August 13, 1973

Anticoagulants in Acute Myocardial InfarctionResults of a Cooperative Clinical Trial

JAMA. 1973;225(7):724-729. doi:10.1001/jama.1973.03220340034009

A lthough anticoagulants have been widely used in the treatment of myocardial infarction for 25 years, there is as yet no consensus as to the benefits derived. The results of a large clinical trial reported by Wright et al1 in 1948 gave evidence that the use of anticoagulants caused a sharp reduction in mortality as well as a reduction in the incidence of thromboembolic complications. Following this report, the use of anticoagulants became a part of the accepted treatment of acute myocardial infarction. Subsequent large clinical trials2-4 have failed to demonstrate a significant decrease in mortality resulting from the use of anticoagulants and have cast doubt on the value of this therapy.

The purpose of the present study was to reexamine the morbidity and mortality of myocardial infarction, with particular emphasis on the thromboembolic complications, and to determine whether the use of anticoagulants alters the incidence of the