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European Heart Journal 1994 15(9):1196-1203;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Prospective evaluation of a prostacyclin-sparing aspiring formulation and heparin/warfarin in aspirin users with unstable angina or non-Q wave myocardial infarction at rest

M. COHEN*,, G. PARRY{dagger}, P.C. ADAMS{dagger}, J. XIONG{ddagger}, D. CHAMBERLAIN{ddagger}, I. WIECZOREK§, K. A. A. FOX§, R. KRONMAL||, V. FUSTER and THE ANTITHROMBOTIC THERAPY IN ACUTE CORONARY SYNDROMES RESEARCH GROUP**

*Division of Cardiology, Department of Medicine, Hahnemann University Hospital Philadelphia, Pennsylvania
{dagger}Department of Cardiology, Royal Victoria Infirmary Newcastle-Upon-Tyne, U.K
{ddagger}Department of Cardiology, Royal Sussex County Hospital Brighton, U.K
§Cardiovascular Research Unit, University of Edinburgh U.K
||Statistics and Epidenmiology Research Corp Seattle, WA
Division of Cardiology, Mount Sinai Hospital New York, N.Y

Received 14 January 1994; revised 13 April 1994; .

Correspondence; Marc Coen, MD, Cardiology MS-119, Hahnemann University Hospital, Broad and Vine Street, Philadelphia, PA 19102–1192, U.S.A.

Abstract

The aim of this trial was to compare the efficacy of combination antithrombotic therapy with a prostacyclin-sparing aspirin plus anticoagulation versus conventional aspirin plus anticoagulation, when added to antianginal therapy, in patients with unstable angina or non-Q wave myocardial infarction already being treated with aspirin. In a double-blind (for the aspirin) study, 144 prior aspirin users were randomized; 72 patients received controiled-release, prostacyclin-sparing aspirin 75 mg daily plus anticoagulation (intravenous heparin followed by warfarin to maintain the international normalized ratio at 2–3), and 72 patients received conventional aspirin 75 mg daily plus the same anticoagulation. Controlled-release aspirin was formulated to preserve endothelial cell prostacyclin synthesis. Trial therapy was begun by 13.2 ± 12.3 h of qualifying pain, and continued for 12 weeks.

The frequency of recurrent angina with electrocardiographic changes, myocardial infarction, or death, was analysed by intention to treat. At 12 weeks, events were

Key Words: Myocardial ischaemia • aspirin • anticoagulation


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