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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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 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?


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]).


20 hospitals in Norway.


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%.


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

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  • For correspondence: Dr M Hurlen, Ullevål University Hospital, Oslo, Norway. Mette.Hurlen{at}

  • Abstract and commentary also appear in ACP Journal Club.

  • Source of funding: Norwegian Council on Cardiovascular Disease.

  • *See glossary.

  • †Information provided by author.