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September 1, 1962

Anticoagulant Therapy in Acute Myocardial Infarction-Reply

Author Affiliations

1125 Fifth Ave., New York City

JAMA. 1962;181(9):805. doi:10.1001/jama.1962.03050350066023

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To the Editor:—  Dr. Howie's attack against anticoagulants is irrelevant to my special communication to The Journal, which was designed exclusively to criticize a specific publication by a group of Danish physicians. Dr. Howie has failed to take issue with the esential criticisms which I made of the Danish report: (1) The study was unsatisfactorily controlled, since treated and untreated patients were not chosen by random selection (alternate case method). (2) Thromboembolic complications, the prevention of which is the major objective of anticoagulant therapy, were significantly reduced, according to the authors' statistical analysis. Therefore, their conclusion that "the use of anticoagulants in acute myocardial infarction should be abandoned" is not justified.The Danish report does not provide evidence to support Dr. Howie's conjecture that deaths from anticoagulants outweigh the benefits of reduction in thromboembolism. Neither does this report indicate an increased incidence of cardiac rupture in the anticoagulated group; in