[Platelet suppressant therapy and oral anticoagulants in the secondary prevention of acute myocardial infarction (authors transl)].

First positive results with platelet suppressant drugs in the secondary prevention of acute myocardial infarction have engendered optimism in the medical and lay community alike. A review of the subject therefore seems appropriate. In the same context a critical reappraisal of the value of long-term anticoagulant therapy after acute myocardial infarction appears also warranted. Results with platelet suppressant therapy reported so far are favorable; however, they fall short from establishing definite proof of the value of such therapy after myocardial infarction. Accordingly, limited clinical use of platelet suppressants may be justifiable by now; it should be borne in mind, however, that such use at the present time still has to be considered experimental. In contrast, there has been statistically well-founded evidence that long-term anticoagulant therapy lowers the mortality after myocardial infarction. It is true, however, that the profit is rather small and that it can be achieved only under rigid control of anticoagulant therapy. Therefore the pros and the cons have to be weighed very carefully for every individual patient, before long-term therapy with oral anticoagulants is started after an acute myocardial infarction. Several large clinical studies are close to completion. It is to be hoped that their outcome will decide, whether platelet suppressant drugs will entirely replace oral anticoagulants in the secondary prevention of acute myocardial infarction.