Aspirin and warfarin versus aspirin monotherapy after myocardial infarction.
OBJECTIVE
To review data concerning combined aspirin/warfarin versus aspirin alone for secondary prevention after myocardial infarction (MI).


METHODS
Literature was accessed through MEDLINE (1966-September 2002). Search terms included aspirin, warfarin, secondary prevention, and myocardial infarction.


RESULTS
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.
D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D006801:Humans; D009203:Myocardial Infarction / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics
D014859:Warfarin; D001241:Aspirin