Oral anticoagulation after myocardial infarction.

In the present review, the role of oral anticoagulants (OAC) in the secondary prevention after myocardial infarction (MI) is discussed in the light of the results from large randomized clinical trials. In particular, recently published trials and meta-analyses including the combination of OAC and low-dose aspirin are presented. The data show a superiority of OAC over aspirin in reducing thromboembolic events after MI. The combined therapy with OAC and low-dose aspirin has been shown to be particularly beneficial, provided the intensity of anticoagulation is adequate (International Normalized Ratio [INR] 2.0-2.5). With this combined therapy, the risk of serious and fatal bleeding complications equals that with OAC alone. Preassumptions for the efficacy and safety of this treatment modality are good patient compliance and strict INR control.