Hennekens C H, O'Donnell C J, Ridker P M
Brigham and Women's Hospital, Department of Medicine, Boston 02215-1204, USA.
Eur Heart J. 1995 Jul;16 Suppl D:2-9. doi: 10.1093/eurheartj/16.suppl_d.2.
Randomised trials of coronary artery patency and mortality support the routine use of antithrombotic therapy in all patients with suspected acute myocardial infarction. At present, it is unclear whether antiplatelet therapy with aspirin alone will suffice or the addition of anticoagulation with either heparin or the newer specific thrombin inhibitor, hirudin, will confer a net benefit. The ongoing randomised trials, such as GUSTO-2 and TIMI-9, will provide relevant information on the use of aspirin plus heparin or aspirin plus hirudin in patients treated with thrombolytic therapy. The First American Study of Infarct Survival (ASIS-1) will provide data which are relevant to the large population of patients who, in the United States, do not receive thrombolytic therapy. When these data become available it will be possible for clinicians to make rational individual decisions and policy-makers to formulate guidelines concerning optimal antithrombotic therapy in myocardial infarction.
关于冠状动脉通畅情况和死亡率的随机试验支持在所有疑似急性心肌梗死患者中常规使用抗血栓治疗。目前，尚不清楚单独使用阿司匹林进行抗血小板治疗是否足够，或者加用肝素或新型特异性凝血酶抑制剂水蛭素进行抗凝治疗是否会带来净获益。正在进行的随机试验，如GUSTO - 2和TIMI - 9，将提供关于在接受溶栓治疗的患者中使用阿司匹林加肝素或阿司匹林加水蛭素的相关信息。美国首次心肌梗死生存研究（ASIS - 1）将为美国大量未接受溶栓治疗的患者提供相关数据。当这些数据可得时，临床医生将能够做出合理的个体化决策，政策制定者也能够制定关于心肌梗死最佳抗血栓治疗的指南。
