ASKEY J M
Calif Med. 1959 Mar;90(3):197-201.
Anticoagulant therapy of arteriosclerotic heart disease may prove to be most valuable when applied on a long-term basis for prevention of recurrent myocardial infarction. While its prophylactic value in impending infarction has not been established, at least the accepted treatment for the acute stage is already begun if an anticoagulant has been administered before an inevitable infarction occurs. The chief value of the anticoagulant, though, seems to lie in preventing cardiac mural thrombosis and extracardiac thromboembolism. It is by this effect, apparently, that mortality has been reduced by 50 per cent among survivors of myocardial infarction who receive continuous dicoumarin therapy. While the danger of hemorrhage is still present, it is being steadily reduced by increasing skill in the management of anticoagulant therapy, and for a long time the risk has been far outweighed by the reduction in coronary occlusion. Physicians have a duty to learn the use of anticoagulant therapy, obtain the facilities necessary for it, and apply it to patients who are able and willing to cooperate in prolonging their useful lives.
对于动脉硬化性心脏病，长期应用抗凝治疗可能证明对预防复发性心肌梗死最有价值。虽然其在即将发生的梗死中的预防价值尚未确立，但如果在不可避免的梗死发生前已给予抗凝剂，那么至少急性期的公认治疗已经开始。然而，抗凝剂的主要价值似乎在于预防心脏壁血栓形成和心外血栓栓塞。显然，正是通过这种作用，接受持续双香豆素治疗的心肌梗死幸存者的死亡率降低了50%。虽然出血风险仍然存在，但随着抗凝治疗管理技能的不断提高，这种风险正在稳步降低，而且长期以来，冠状动脉闭塞减少带来的益处远远超过了风险。医生有责任学习抗凝治疗的使用方法，获得必要的设备，并将其应用于有能力且愿意配合以延长其有效生命的患者。
