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Semin Vasc Med 2003; 03(3): 323-332
DOI: 10.1055/s-2003-44468
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Oral Anticoagulant Therapy in Patients with Coronary Artery Disease

Daniel G. Hackam1 , Sonia S. Anand1,2,3 , Salim Yusuf1,2,3
  • 1Department of MedicineMcMaster University, Hamilton, Ontario, Canada
  • 2Division of Cardiology, McMaster University, Hamilton, Ontario, Canada
  • 3Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
Further Information

Publication History

Publication Date:
21 November 2003 (online)

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ABSTRACT

Oral anticoagulation (OA) has been used to treat patients with coronary artery disease (CAD) for more than 40 years and has been a subject of intense controversy since that time. Seven to 10% of patients with acute myocardial infarction (MI) develop recurrent MI, stroke, or death in the 6 weeks following the index event and approximately 20% after 4 years, despite optimal background therapy with aspirin. Recent large studies and systematic reviews have greatly clarified the role of OA in the modern era. On the weight of the evidence, which is reviewed in detail in this article, long-term, moderate-intensity OA (International Normalized Ratio 2.0 to 3.0) should be considered an option for the prevention of recurrent CAD, particularly in high-risk patients.

KEYWORDS

Oral anticoagulants - coronary artery disease - prevention

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