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The Annals of Pharmacotherapy: Vol. 37, No. 10, pp. 1502-1505. DOI 10.1345/aph.1C474
© 2003 Harvey Whitney Books Company.
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DRUG INFORMATION ROUNDS

Aspirin and Warfarin Versus Aspirin Monotherapy After Myocardial Infarction

Azzah S Jeddy

PharmD Student, St. Louis College of Pharmacy, St. Louis, MO

Brenda L Gleason, PharmD

Assistant Professor, Division of Pharmacy Practice, St. Louis College of Pharmacy

Reprints: Brenda L Gleason PharmD, Division of Pharmacy Practice, St. Louis College of Pharmacy, 4588 Parkview Pl., St. Louis, MO 63110-1088, FAX 314/454-3375, bgleason{at}stlcop.edu

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

DATA SOURCES: Literature was accessed through MEDLINE (1966–September 2002). Search terms included aspirin, warfarin, secondary prevention, and myocardial infarction.

DATA SYNTHESIS: 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.

Key Words: aspirin, combination therapy, myocardial infarction, secondary prevention, warfarin

Published Online, August 15, 2003. www.theannals.com, DOI 10.1345/aph.1C474


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