Management of thrombosis in coronary heart disease.

Management of thrombosis in coronary heart disease comprises the management of acute coronary thrombosis presenting as myocardial infarction or as unstable angina, the use of anticoagulant therapy to prevent or treat complications of myocardial infarction, and prophylaxis in patients identified as being at increased risk. Thrombolytic therapy and aspirin independently and additively reduce mortality in evolving myocardial infarction. Aspirin and heparin, but not thombolytic agents, improve outcome in unstable angina. Heparin and warfarin reduce the risk of embolism from left ventricular thrombus forming post-infarction. Aspirin has been shown to reduce the risk of further cardiovascular events or cardiac death in patients identified as at high risk. Current research is evaluating the role of antithrombins and platelet adhesion inhibitors as adjuvant therapy after thrombolysis, in unstable angina, and as heparin substitutes during coronary angioplasty, and of low dose warfarin as long-term prophylaxis in high risk patients.