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Coumadin Aspirin Reinfarction Study: Rationale and Design of the CARS Study
1The Cardiovascular Institute, Mount Sinai Medical Center, New York, NY.
Insights
This study investigates if combining Coumadin and aspirin is safer and more effective than aspirin alone for preventing recurrent heart attacks in survivors. Results will guide optimal antithrombotic therapy after myocardial infarction.
Area of Science:
- Cardiology
- Thrombosis Research
- Clinical Trials
Background:
- Acute myocardial infarction is a leading cause of death.
- Thrombosis plays a key role in myocardial infarction pathogenesis.
- Antiplatelet and anticoagulant therapies reduce recurrent infarction, but optimal regimens are unknown.
Purpose of the Study:
- To compare the safety and efficacy of combination therapy (Coumadin plus aspirin) versus aspirin alone.
- To determine the optimal antithrombotic regimen for survivors of acute myocardial infarction.
- To investigate the role of combination antithrombotic therapy in preventing reinfarction.
Main Methods:
- The Coumadin Aspirin Reinfarction Study (CARS) is a large-scale clinical trial.
- Enrollment of 8000 survivors of acute myocardial infarction.
- Comparison of fixed-dose combination Coumadin plus aspirin against aspirin alone, with up to 4 years of patient follow-up.
Main Results:
- This section is to be filled upon study completion.
Conclusions:
- This section is to be filled upon study completion.
Abstract:
Acute myocardial infarction remains the leading cause of death in the United States. Following increased recognition of the role of thrombosis in the pathogenesis of myocardial infarction, both antiplatelet and anticoagulant therapy have been proven effective in preventing recurrent infarction. However, the optimal antithrombotic regimen remains undetermined. In particular, the role of combination antithrombotic therapy has not been studied. The Coumadin Aspirin Reinfarction Study (CARS) will compare the safety and efficacy of fixed-dose combination Coumadin plus aspirin versus aspirin alone among 8000 survivors of acute myocardial infarction. Patients will be followed for up to 4 years. CARS will provide important information regarding the optimal antithrombotic regimen for myocardial infarct survivors.