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document
Long-term anticoagulant treatment after acute myocardial infarction . The Warfarin Re-Infarction Study . High levels of fibrinogen and clotting factor VII are associated with an increased risk for subsequent death and cardiovascular disease in apparently healthy individuals . Furthermore , pathoanatomic studies and coronary angiography have confirmed a relationship between coronary thrombus formation and acute Q-wave infarction . Effective antithrombotic agents may prevent or limit thrombus formation and events related to thrombosis . The Warfarin Re-Infarction Study ( WARIS ) studied the effect of warfarin in survivors of acute myocardial infarction . Patients aged 75 years or less were randomized in a double-blind , placebo-controlled study to test whether long-term treatment with warfarin reduces the risk of death , reinfarction , and thromboembolic morbidity . A total of 1918 patients were screened for participation ; 1214 were recruited . The mean follow-up was 37 months . Analyzed on an intention-to-treat basis , 123 ( 20 % ) in the placebo group died , versus 94 ( 15 % ) in the warfarin group , a risk reduction of 24 % ( P = 0.026 ) . Considering patients on treatment or within 28 days after discontinuing the test medication , 92 in the placebo group died , as compared with 60 of the warfarin-treated patients , a risk reduction of 35 % ( P = 0.005 ) . Relapsing myocardial infarction ( fatal and nonfatal ) was reduced by 43 % ( P = 0.0001 ) . The incidence of cerebrovascular attacks was lower in the warfarin group ( 16 patients ) than the placebo group ( 41 patients ) , a highly significant reduction of 61 % ( P = 0.0003 ) . Serious bleeding occurred in 11 patients taking warfarin , an incidence of 0.6 % per year . In conclusion , long-term anticoagulant therapy may be recommended after acute myocardial infarction .
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Intervention_Control
anticoagulant treatment
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Intervention_Pharmacological
warfarin
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
warfarin
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Intervention_Control
placebo
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Intervention_Pharmacological
warfarin
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Intervention_Pharmacological
warfarin-treated
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Intervention_Pharmacological
warfarin
14204
Intervention_Control
placebo
14205
Intervention_Pharmacological
warfarin
14206
Outcome_Physical
increased risk
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Outcome_Mortality
subsequent death
14208
Outcome_Physical
cardiovascular disease
14209
Outcome_Physical
thrombus formation
14210
Outcome_Adverse-effects
events related to thrombosis .
14211
Outcome_Physical
risk
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Outcome_Mortality
death , reinfarction
14213
Outcome_Physical
thromboembolic morbidity
14214
Outcome_Mortality
died
14215
Outcome_Physical
risk reduction
14216
Outcome_Mortality
died
14217
Outcome_Other
risk reduction
14218
Outcome_Physical
Relapsing myocardial infarction ( fatal and nonfatal )
14219
Outcome_Physical
incidence of cerebrovascular attacks
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Outcome_Adverse-effects
Serious bleeding
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Participant_Condition
acute myocardial infarction
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Participant_Sample-size
1918
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Participant_Sample-size
1214