title: Aspirin, warfarin and a thienopyridine for acute coronary syndromes.
abstract: BACKGROUND
  Although clopidogrel and aspirin (dual therapy, DT) are used for acute coronary syndrome (ACS), sometimes treatment with warfarin (triple therapy, TT) is required.
  
  
  OBJECTIVE
  To determine the incidence, complications, and outcomes of TT.
  
  
  METHODS
  We analyzed Israeli surveys of ACS from 2000 to 2004.
  
  
  RESULTS
  In these surveys, 5,706 (96%) were discharged alive from hospital. Post-ACS TT and DT were 76 patients (1.3%) and 2,661 patients (46.7%), respectively. The TT group was older with more prior cardiac disease. During hospitalization, the TT patients received more intravenous anticoagulant and antithrombotic agents, and had more heart failure, arrhythmias, ischemia, and major bleeding (2.6 vs. 0.6%, p=0.03). There were no differences in adjusted 30-day and 6-month mortality between the 2 groups.
  
  
  CONCLUSIONS
  TT is feasible among ACS patients who require concomitant warfarin treatment.
authors.affiliation: Department of Cardiology, Rabin Medical Center, Petah-Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Konstantino
authors.forename: Zaza
authors.initials: Z
authors.lastname: Iakobishvili
authors.forename: Avital
authors.initials: A
authors.lastname: Porter
authors.forename: Amir
authors.initials: A
authors.lastname: Sandach
authors.forename: Doron
authors.initials: D
authors.lastname: Zahger
authors.forename: Hanoch
authors.initials: H
authors.lastname: Hod
authors.forename: Haim
authors.initials: H
authors.lastname: Hammerman
authors.forename: Shmuel
authors.initials: S
authors.lastname: Gottlieb
authors.forename: Solomon
authors.initials: S
authors.lastname: Behar
authors.forename: David
authors.initials: D
authors.lastname: Hasdai
mesh_terms: D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D000077144:Clopidogrel; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D004359:Drug Therapy, Combination; D005260:Female; D006401:Hematologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D013577:Syndrome; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016276:Ventricular Function; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D006401:Hematologic Agents; D011725:Pyridines; C446540:thienopyridine; D014859:Warfarin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin