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AFTERAspirin/Anticoagulants Following Thrombolysis withanistreplase (Eminase) in Recurrent infarction. |
| Authors: |
Julian DG, Chamberlain DA, Pocock SJ |
| Titles: |
A comparison of aspirin and anticoagulation following thrombolysis for myocardial infarction (the AFTER study): a multicentre unblinded randomised clinical trial |
| References: |
BMJ 1996;313:1429-31 |
| Disease: |
AMI |
| Purpose: |
To compare the effect on cardiac death and reinfarction of aspirin with anticoagulant therapy |
| Study Design: |
Randomised, open, controlled |
| Follow-up: |
30 days, 3 months |
| Patients: |
1036 patients (aim 1856). Time since onset of symptoms: = 6 h |
| Treatmentregimen: |
All patients anistreplase, 30 U, then randomised to either aspirin, 150 mg/day, or heparin, 1000 U/h iv for 24 h, beginning 6 h after anistreplase, plus oral anticoagulants to maintain an international normalised ratio in the range 2.0-2.5. Both regimens |
| Results: |
There were no significant differences in the incidence of cardiac events between the two groups. After 30 days, cardiac death or reinfarction occurred in 11% of the anticoagulation group and 11.2% of the aspirin group. At 3 months, the corresponding rates were 13.2% (anticoagulation) and 12.1% (aspirin). Severe bleeding or stroke by 3 months was more common in the anticoagulation group than in the aspirin group (3.9% vs 1.7%; p = 0.04) | |
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