The value of anticoagulants in the prophylaxis and therapy of ischaemic heart disease.

Although there is no general agreement as to the role that anticoagulants can-or should-play in the prevention and treatment of myocardial infarction, nevertheless their use during the first 6-12 weeks after occlusion of a coronary artery seems to be well established for preventing both venous and cardiac thromboses and consequent embolism and thus lowering the mortality during that period. The data at present available suggest that in the prevention of recurrences of myocardial infarction long-term anticoagulant treatment gives less spectacular but at least encouraging results. Only recently have large-scale investigations been conducted into the prevention of the first infarct by long-term use of anticoagulants in angina pectoris; the results to date appear very promising, particularly in acute coronary insufficiency.While there is a very real danger of haemorrhage during long-term anticoagulant treatment, the author considers that haemorrhage need rarely be severe or fatal provided strict attention is paid to contra-indications (e.g., hypertension) and provided adequate control of the patient is ensured.