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Warfarin and aspirin versus aspirin alone in patients with acute myocardial infarction: a pilot study

M J Zibaeenezhad1, A Mowla, M H Sorbi

  • 1Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Zibaeem2@sums.ac.ir

Angiology
|February 5, 2004
PubMed

Insights

Combining warfarin and aspirin (ASA) after myocardial infarction (MI) did not improve outcomes compared to aspirin alone. The combination therapy led to a significantly higher incidence of minor bleeding events in MI survivors.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Secondary prevention of myocardial infarction (MI) often involves anticoagulant and antiplatelet agents.
  • The combined use of warfarin and aspirin (ASA) for post-MI secondary prevention remains understudied.

Purpose of the Study:

  • To compare the efficacy and safety of combined warfarin and ASA versus ASA alone in patients following MI.
  • To evaluate outcomes including hemorrhage, reinfarction, and rehospitalization.

Main Methods:

  • A randomized trial involving 140 MI survivors.
  • Group A received ASA (100 mg/day) plus warfarin (target INR 2-3).
  • Group B received ASA (100 mg/day) alone. Outcomes were monitored for 1 year.

Main Results:

  • Minor hemorrhagic episodes were significantly more frequent in the warfarin plus ASA group (p = 0.002).
  • Rehospitalization and reinfarction rates were lower in the combination group but did not reach statistical significance.
  • No significant clinical benefit was observed with combined therapy over aspirin monotherapy.

Conclusions:

  • Warfarin plus ASA did not offer additional clinical benefit compared to aspirin monotherapy in post-MI patients.
  • Given the increased risk of minor hemorrhage, antiplatelet therapy alone appears to be a more reasonable approach for secondary prevention after MI.

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