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  • Warfarin alone or with aspirin was superior to aspirin alone after acute myocardial infarction but increased bleeding

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Therapeutics
Warfarin alone or with aspirin was superior to aspirin alone after acute myocardial infarction but increased bleeding

https://doi.org/10.1136/ebm.8.2.42

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    (2002) N Engl J Med 347, 969. Hurlen M, Abdelnoor M, Smith P, et al.. Warfarin, aspirin, or both after myocardial infarction.. ;. :. –74.
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 QUESTION: In patients who had an acute myocardial infarction (MI), what is the efficacy and safety of long term treatment with warfarin plus aspirin, warfarin alone, or aspirin alone?

    Design

    Randomised (allocation concealed*), blinded {data collectors, outcome assessors, monitoring committee, and data analysts}†,* controlled trial with mean follow up of 1445 days (about 4 y) (Warfarin, Aspirin, Reinfarction Study [WARIS II]).

    Setting

    20 hospitals in Norway.

    Patients

    3630 patients <75 years of age who were admitted to hospital for, and had survived, an acute MI. Exclusion criteria included malignant disease. Follow up was 99.6%.

    Intervention

    Patients were allocated to warfarin, with the goal of achieving an international normalised ratio (INR) of …

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    Footnotes

    • For correspondence: Dr M Hurlen, Ullevål University Hospital, Oslo, Norway. Mette.Hurlen{at}ulleval.no

    • Abstract and commentary also appear in ACP Journal Club.

    • Source of funding: Norwegian Council on Cardiovascular Disease.

    • ↵*See glossary.

    • ↵†Information provided by author.