EVIDENCE FAVORING USE OF ANTICOAGULANTS IN HOSPITAL PHASE OF ACUTE MYOCARDIAL-INFARCTION
EVIDENCE FAVORING USE OF ANTICOAGULANTS IN HOSPITAL PHASE OF ACUTE MYOCARDIAL-INFARCTION
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DOI：
10.1056/nejm197711172972004
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发表时间：
1977-01-01
影响因子：
158.5
通讯作者：
KUNZLER, AM
中科院分区：
文献类型：
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作者：
CHALMERS, TC;MATTA, RJ;KUNZLER, AM
自上一次对急性心肌梗死抗凝治疗进行全面综述以来，报告了另外4项随机对照试验。绝大多数试验支持抗凝治疗。对照组血栓栓塞发生率较高，抗凝组出血并发症发生率较高。所有随机对照试验的汇总显示，对照组的平均病死率为19.6%，抗凝组为15.4%，相对降低21%（P < 0.05或< 0.001，取决于分析方法）。6项随机对照试验中有5项报告无影响，因为有利于抗凝的差异无统计学显著性。然而，这些阴性论文中的样本量太小，无法防止由于抗凝而导致的真实病例死亡率降低21%（β）。> 0.10）。所有没有特殊禁忌症的患者在因梗死住院期间应接受抗凝剂治疗。
Since the last comprehensive review of anticoagulation in acute myocardial infarction 4 additional randomized control trials were reported. The overwhelming majority of all trials favored anticoagulation. Rates of thromboembolism were higher in the control, and hemorrhagic complications in the anticoagulated group. Pooling of all randomzied control trials gives mean case fatality rates of 19.6% for the control and 15.4% for the anticoagulated group, a relative reduction of 21% (P < 0.05 or < 0.001, depending on the analytic method). Five of 6 randomized control trials reported no effect because the difference favoring anticoagulation was not statistically significant. However, sample sizes in these negative papers were too small to protect against missing a 21% reduction in true case fatality rate due to anticoagulation (.beta. > 0.10). All patients who present no specific contraindication should receive anticoagulants during hospitalization for infarction.