6.5.1.1In patients after acute MI high-intensity warfarin compared to placebo is associated with reduction in cardiovascular events and mortality (Grade 1+).
6.5.1.2There is inconsistent evidence that high-intensity warfarin is more effective than aspirin in reduction of mortality or reinfarction and stroke (Grade 1+).
6.5.1.3High-intensity warfarin is associated with a higher incidence of major bleeding compared to aspirin (1+).
6.5.1.4Treatment with aspirin is likely to be more cost effective when compared with with warfarin in patients with CAD.
6.5.1.5In patients after acute MI, the combination of low intensity warfarin and aspirin did not consistently reduce the incidence of major cardiovascular events compared to aspirin on its own, and was associated with an increased risk of haemorrhagic complications (1+).
6.5.1.6In patients after an acute MI, the combination of moderate intensity warfarin (target INR 2 to 2.5) and aspirin compared to aspirin on its own resulted in a reduction in the composite end point of death, non- fatal MI or stroke (1+).
6.5.1.7In patients after an acute MI, the combination of moderate intensity warfarin (target INR 2 to 2.5) and aspirin compared to aspirin on its own was associated with an increased risk of bleeding (Grade 1+).
6.5.1.8In patients after acute MI, the combination of moderate intensitywarfarin (target INR 2 to 2.5) and aspirin did not reduce the incidence of major cardiovascular events compared to high intensity warfarin (target INR 2.8 to 4.2) on its own, and was associated with a similar risk of bleeding (Grade 1+).

From: 6, Drug Therapy

Cover of Post Myocardial Infarction
Post Myocardial Infarction: Secondary Prevention in Primary and Secondary Care for Patients Following a Myocardial Infarction [Internet].
NICE Clinical Guidelines, No. 48.
National Collaborating Centre for Primary Care (UK).
Copyright © 2007, National Collaborating Centre for Primary Care.

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