Document Detail


Efficacy of long-term anticoagulant treatment in subgroups of patients after myocardial infarction.
MedLine Citation:
PMID:  7546987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the efficacy of long term oral anticoagulant treatment in subgroups of patients after myocardial infarction. DESIGN: Analysis of the effect of anticoagulant treatment in subgroups of hospital survivors of myocardial infarction based upon age, gender, history of hypertension, previous myocardial infarction, smoking habits, diabetes mellitus, Killip class, anterior location of infarction, thrombolytic therapy, and use of beta blockers. SUBJECTS: Participants of a multicentre, randomised, double blind, placebo controlled trial that assessed the effect of oral anticoagulant treatment on mortality as well as cerebrovascular and cardiovascular morbidity in 3404 hospital survivors of acute myocardial infarction. MAIN OUTCOME MEASURES: The effect of anticoagulant treatment on recurrent myocardial infarction, cerebrovascular events, and vascular events (the composite endpoint of reinfarction, cerebrovascular event, and vascular death). RESULTS: Long term anticoagulant treatment was associated with a reduction in mortality of 10% (95% confidence interval -11% to 27%), recurrent myocardial infarction of 53% (41% to 62%), cerebrovascular events of 40% (10% to 60%) and vascular events of 35% (24% to 45%). Treatment effect with respect to recurrent myocardial infarction was comparable among all subgroups of patients. Although treatment effect appeared to be somewhat smaller in females than in males (-11% v -45%), and in patients with diabetes compared to those without (-14% v -42%) with respect to vascular events, none of these differences reached statistical significance. In multivariate analysis, more advanced age, previous myocardial infarction, diabetes mellitus, and heart failure during admission were independently associated with increased incidence of cardiovascular complications. CONCLUSIONS: The relative benefit of long term anticoagulant therapy in survivors of myocardial infarction is not modified by known prognostic factors for cardiovascular disease.
Authors:
P F van Bergen; J W Deckers; J J Jonker; R T van Domburg; A J Azar; A Hofman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British heart journal     Volume:  74     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-11-14     Completed Date:  1995-11-14     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  117-21     Citation Subset:  AIM; IM    
Affiliation:
ASPECT Coordinating Centre, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Anticoagulants / therapeutic use*
Cardiovascular Diseases / complications
Diabetes Complications
Female
Follow-Up Studies
Heart Failure / complications
Humans
Male
Middle Aged
Morbidity
Multivariate Analysis
Myocardial Infarction / drug therapy,  mortality,  prevention & control*
Prognosis
Recurrence
Sex Factors
Chemical
Reg. No./Substance:
0/Anticoagulants
Comments/Corrections

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