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European Heart Journal 1995 16(Supplement D):2-9; doi:10.1093/eurheartj/16.suppl_D.2
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Current and future perspectives on antithrombotic therapy of acute myocardial infarction

C. H. Hennekens*,§, C. J. O'Donnell*,{ddagger} and P. M. Ridker*,{dagger}

* From the Brigham and Women's Hospital, Department of Medicine, Divisions of Preventative Medicine Boston, MA, U.S.A.
§ From the Brigham and Women's Hospital, Department of Medicine, Cardiology, Boston, MA; Veterans Affairs Medical Center, Department of Medicine Boston, MA, U.S.A.
{ddagger} From the Brigham and Women's Hospital, Department of Medicine, Section of Cardiology, West Roxbury, MA; Harvard Medical School Boston, MA, U.S.A.
{dagger} From the Brigham and Women's Hospital, Department of Medicine, Department of Ambulatory Care and Prevention Boston, MA, U.S.A.

Randomised trials of coronary artery patency and mortality support the routine use of antithrombotic therapy in all patients with suspected acute myocardial infarction. At present, it is unclear whether antiplatelet therapy with aspirin alone will sujice or the addition of anticoagulation with either heparin or the newer specific thrombin inhibitor, hirudin, will confer a net benefit. The ongoing rundomised trials, such as GUSTO-2 and TIMI-9, will provide relevant information on the use of aspirin plus heparin or aspirin plus hirudin in patients treated with thrombolytic therapy. The First American Study of Infarct Survival (ASIS-1) will provide data which are relevant to the large population of patients who, in the United States, do not receive thrombolytic therapy. When these data become available it will be possible for clinicians to make rational individual decisions and policy-makers to formulate guidelines concerning optimal antithrombotic therapy in myocardial infarction.

Key Words: Thrombosis • antithrombotic drugs • heparin • hirudin • myocardial infarction • aspirin • thrombolysis


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