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November 27, 1981, Vol 246, No. 21 >
ARTICLE | November 27, 1981

Drug Prophylaxis for Arterial Thromboembolism—1981 FREE

Stanford Wessler, MD
[+] Author Affiliations

Read in part before The Scientific Sessions, American Heart Association, Miami, Nov 18, 1980.

Reprint requests to The New York University School of Medicine, 550 First Ave, New York, NY 10016.


JAMA. 1981;246(21):2484-2487. doi:10.1001/jama.1981.03320210050027
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References

Recent multicenter clinical trials using platelet-suppressive agents for the secondary prevention of myocardial infarction have yielded inconclusive results, although some of the data suggest possible benefits. For transient ischemic attacks, after carotid artery surgery has been eliminated as an option, aspirin is the drug of choice for men; for women, and for men in whom aspirin fails, warfarin sodium should be considered. Warfarin is indicated after insertion of cardiac prosthetic disk valves, and if systemic emboli occur, dipyridamole should be added. Patients with atrial fibrillation should be treated prophylactically with coumarin agents, but only if underlying organic heart disease is demonstrable.

(JAMA 1981;246:2484-2487)

REFERENCES

1 +
Chandler AB, Eurenuis K, McMillan GC, et al (eds): The Thrombotic Process in Atherogenesis . New York, Plenum Press, 1978;, pp 1-546.
2 +
 Proceedings of the Workshop on Platelet-Active Drugs in the Secondary Prevention of Cardiovascular Events . Circulation 1980;; 62( (suppl 5) ):1-135.
3 +
Butler S: The Note-books of Samuel Butler . London, AC Fifield, 1912;, p 11.
4 +
Hull R, Delmore T, Carter C, et al:  A randomized trial of titrated dose subcutaneous (s.c.) heparin versus warfarin in long term treatment of patients with deep venous thrombosis (VT) , abstracted. Circulation 1980;;62( (suppl 3) ):338.
5 +
 A randomized control trial of aspirin in persons recovered from myocardial infarction, Aspirin Myocardial Infarction Study Research Group . JAMA 1980;;243:661-669.
6 +
Fields WS, Lemak NA, Frankowski RF, et al:  Controlled trial of aspirin in cerebral ischemia . Stroke 1977;;8:301-316.
7 +
 A randomized trial of aspirin and sulfinpyrazone in threatened stroke, The Canadian Cooperative Study Group . N Engl J Med 1978;; 299:53-59.
8 +
Millikan CH:  Transient cerebral ischemia: Definition and natural history . Prog Cardiovasc Dis 1980;;22:303-308.
9 +
Goldner JC, Whisnant JP, Taylor WF:  Long-term prognosis of transient cerebral ischemic attacks . Stroke 1971;;2:160-167.
10 +
Schmidley JW, Caronna JJ:  Transient cerebral ischemia: Pathophysiology . Prog Cardiovasc Dis 1980;;22:325-342.
11 +
Mohr JP:  Transient ischemic attacks and the prevention of strokes . N Engl J Med 1978;; 299:93-95.
12 +
Sullivan JM, Harken DE, Gorlin R:  Pharmacologic control of thromboembolic complications of cardiac-valve replacement . N Engl J Med 1971;;284:1391-1394.
13 +
Tinker JH, Tarham S:  Discontinuing anticoagulant therapy in surgical patients with cardiac valve prostheses: Observations in 180 operations . JAMA 1978;;239:738-739.
14 +
Wessler S, Gitel SN:  Thrombosis: The relationship of hemostatic mechanisms to drug therapy . J Neurosurg 1981;;54:1-11.
15 +
Wessler S:  Thrombosis and sex hormones: A perplexing liaison . J Lab Clin Med 1980;; 96:757-761.
16 +
Hall JG, Pauli RM, Wilson KM:  Maternal and fetal sequelae of anticoagulation during pregnancy . Am J Med 1980;;68:122-140.
17 +
Becker CG, Dubin T:  Activation of factor XII by tobacco glycoprotein . J Exp Med 1977;; 146:457-467.
18 +
Wessler S:  Atherothrombology , in Chandler AB, Eurenuis K, McMillan GC, et al (eds): The Thrombotic Process in Atherogenesis . New York, Plenum Press, 1978;, pp 409-417.
19 +
Steele P, Rainwater J:  Favorable effect of sulfinpyrazone on thromboembolism in patients with rheumatic heart disease . Circulation 1980;; 62:462-468.
20 +
Easton JD, Sherman DG:  Progress in cerebrovascular disease: Management of cerebral embolism of cardiac origin . Stroke 1980;; 11:433-442.
21 +
Bjerkelund C, Orning OM:  The efficacy of anticoagulant therapy in preventing embolism related to DC electrical conversion of atrial fibrillation . Am J Cardiol 1969;;23:208-216.
22 +
Demakis JG, Shahbudin HR, Sutton GC, et al:  Natural course of peripartum cardiomyopathy . Circulation 1971;;44:1053-1061.
23 +
McDonald CD, Burch GE, Walsh JJ:  Prolonged bedrest in treatment of idiopathic cardiomyopathy . Am J Med 1972;;52:41-50.
24 +
Wessler S, Kleiger RD, Cornfield J, et al:  Coumarin therapy in acute myocardial infarction: A Hobsen's choice . Arch Intern Med 1974;; 134:774-779.
25 +
Chalmers TC, Matta RJ, Smith H Jr, et al:  Evidence favoring the use of anticoagulants in the hospital phase of acute myocardial infarction . N Engl J Med 1977;;297:1091-1096.
26 +
Fisher CM:  Reducing risks of cerebral embolism . Geriatrics 1979;;34:59-66.
27 +
Cabin HS, Roberts WC:  Left ventricular aneurysm, intraaneurysmal thrombus and systemic embolus in coronary heart disease . Chest 1980;;77:586-590.
28 +
Staffurth JS, Gibberd MC, Fui SNT:  Arterial embolism in thyrotoxicosis with atrial fibrillation . Br Med J 1977;;3:688-690.
29 +
Fairfax AJ, Lambert CD, Leatham A:  Systemic embolism in chronic sinoatrial disorders . N Engl J Med 1976;;295:190-192.
30 +
Darsee JR, Mikolich JR, Nicoloff NB, et al:  Prevalence of mitral valve prolapse in presumably healthy young men . Circulation 1979;;59:619-622.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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1 +
Chandler AB, Eurenuis K, McMillan GC, et al (eds): The Thrombotic Process in Atherogenesis . New York, Plenum Press, 1978;, pp 1-546.
2 +
 Proceedings of the Workshop on Platelet-Active Drugs in the Secondary Prevention of Cardiovascular Events . Circulation 1980;; 62( (suppl 5) ):1-135.
3 +
Butler S: The Note-books of Samuel Butler . London, AC Fifield, 1912;, p 11.
4 +
Hull R, Delmore T, Carter C, et al:  A randomized trial of titrated dose subcutaneous (s.c.) heparin versus warfarin in long term treatment of patients with deep venous thrombosis (VT) , abstracted. Circulation 1980;;62( (suppl 3) ):338.
5 +
 A randomized control trial of aspirin in persons recovered from myocardial infarction, Aspirin Myocardial Infarction Study Research Group . JAMA 1980;;243:661-669.
6 +
Fields WS, Lemak NA, Frankowski RF, et al:  Controlled trial of aspirin in cerebral ischemia . Stroke 1977;;8:301-316.
7 +
 A randomized trial of aspirin and sulfinpyrazone in threatened stroke, The Canadian Cooperative Study Group . N Engl J Med 1978;; 299:53-59.
8 +
Millikan CH:  Transient cerebral ischemia: Definition and natural history . Prog Cardiovasc Dis 1980;;22:303-308.
9 +
Goldner JC, Whisnant JP, Taylor WF:  Long-term prognosis of transient cerebral ischemic attacks . Stroke 1971;;2:160-167.
10 +
Schmidley JW, Caronna JJ:  Transient cerebral ischemia: Pathophysiology . Prog Cardiovasc Dis 1980;;22:325-342.
11 +
Mohr JP:  Transient ischemic attacks and the prevention of strokes . N Engl J Med 1978;; 299:93-95.
12 +
Sullivan JM, Harken DE, Gorlin R:  Pharmacologic control of thromboembolic complications of cardiac-valve replacement . N Engl J Med 1971;;284:1391-1394.
13 +
Tinker JH, Tarham S:  Discontinuing anticoagulant therapy in surgical patients with cardiac valve prostheses: Observations in 180 operations . JAMA 1978;;239:738-739.
14 +
Wessler S, Gitel SN:  Thrombosis: The relationship of hemostatic mechanisms to drug therapy . J Neurosurg 1981;;54:1-11.
15 +
Wessler S:  Thrombosis and sex hormones: A perplexing liaison . J Lab Clin Med 1980;; 96:757-761.
16 +
Hall JG, Pauli RM, Wilson KM:  Maternal and fetal sequelae of anticoagulation during pregnancy . Am J Med 1980;;68:122-140.
17 +
Becker CG, Dubin T:  Activation of factor XII by tobacco glycoprotein . J Exp Med 1977;; 146:457-467.
18 +
Wessler S:  Atherothrombology , in Chandler AB, Eurenuis K, McMillan GC, et al (eds): The Thrombotic Process in Atherogenesis . New York, Plenum Press, 1978;, pp 409-417.
19 +
Steele P, Rainwater J:  Favorable effect of sulfinpyrazone on thromboembolism in patients with rheumatic heart disease . Circulation 1980;; 62:462-468.
20 +
Easton JD, Sherman DG:  Progress in cerebrovascular disease: Management of cerebral embolism of cardiac origin . Stroke 1980;; 11:433-442.
21 +
Bjerkelund C, Orning OM:  The efficacy of anticoagulant therapy in preventing embolism related to DC electrical conversion of atrial fibrillation . Am J Cardiol 1969;;23:208-216.
22 +
Demakis JG, Shahbudin HR, Sutton GC, et al:  Natural course of peripartum cardiomyopathy . Circulation 1971;;44:1053-1061.
23 +
McDonald CD, Burch GE, Walsh JJ:  Prolonged bedrest in treatment of idiopathic cardiomyopathy . Am J Med 1972;;52:41-50.
24 +
Wessler S, Kleiger RD, Cornfield J, et al:  Coumarin therapy in acute myocardial infarction: A Hobsen's choice . Arch Intern Med 1974;; 134:774-779.
25 +
Chalmers TC, Matta RJ, Smith H Jr, et al:  Evidence favoring the use of anticoagulants in the hospital phase of acute myocardial infarction . N Engl J Med 1977;;297:1091-1096.
26 +
Fisher CM:  Reducing risks of cerebral embolism . Geriatrics 1979;;34:59-66.
27 +
Cabin HS, Roberts WC:  Left ventricular aneurysm, intraaneurysmal thrombus and systemic embolus in coronary heart disease . Chest 1980;;77:586-590.
28 +
Staffurth JS, Gibberd MC, Fui SNT:  Arterial embolism in thyrotoxicosis with atrial fibrillation . Br Med J 1977;;3:688-690.
29 +
Fairfax AJ, Lambert CD, Leatham A:  Systemic embolism in chronic sinoatrial disorders . N Engl J Med 1976;;295:190-192.
30 +
Darsee JR, Mikolich JR, Nicoloff NB, et al:  Prevalence of mitral valve prolapse in presumably healthy young men . Circulation 1979;;59:619-622.

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