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Published on: February 28, 2012
Aspirin and warfarin versus aspirin monotherapy after myocardial infarction
Azzah S Jeddy1, Brenda L Gleason
1St. Louis College of Pharmacy, St. Louis, MO, USA.
Objective:
To review data concerning combined aspirin/warfarin versus aspirin alone for secondary prevention after myocardial infarction (MI).
Data Sources:
Literature was accessed through MEDLINE (1966-September 2002). Search terms included aspirin, warfarin, secondary prevention, and myocardial infarction.
Data Synthesis:
Despite use of low-dose aspirin after an MI, risk of subsequent death and ischemic events remains high, making strategies for secondary prevention imperative. Relevant, large, long-term studies focusing on dual aspirin/warfarin versus aspirin alone in post-MI patients were evaluated.
Conclusions:
Aspirin 75-325 mg/d should remain first-line therapy for secondary prevention after MI. Combining aspirin 75-81 mg with warfarin to maintain the international normalized ratio at 2.0-2.5 may provide added benefit, but should be considered only for patients at high risk for thromboembolic events.
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