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November 1976

The Case for Anticoagulants in Acute Myocardial Infarction: How Do You Know You Cannot Do It Better?

Author Affiliations

Tel Hashomer, Israel

Arch Intern Med. 1976;136(11):1230-1231. doi:10.1001/archinte.1976.03630110006004

The practice of medicine is undergoing continuous change, and this change is not always in the same direction. Sometimes change considered to be an advancement may not turn out as such, and we may find ourselves back at the starting point. Anticoagulant therapy may be a case in point.

Having received a tremendous impetus following the initial trial conducted by Irving Wright,1 and having undergone a tortuous trial-and-error period for the next two decades, the use of anticoagulants in myocardial infarction has been practically discontinued following Gifford and Feinstein's2 comprehensive analysis in 1969. In that particular communication, the authors reviewed all studies reported in the English literature in terms of whether the conclusions followed logically from the way the study was designed and the way, the data were collected, tabulated, and analyzed. All but one of the studies had not complied with the criteria of a valid clinical

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