Drug prophylaxis for arterial thromboembolism--1981

S. Wessler

Recent multicenter clinical trials using platelet-suppressive agents for the secondary prevention of myocardial infarction have yielded inconclusive results, although some of the data suggest possible benefits. For transient ischemic attacks, after carotid artery surgery has been eliminated as an option, aspirin is the drug of choice for men; for women, and for men in whom aspirin fails, warfarin sodium should be considered. Warfarin is indicated after insertion of cardiac prosthetic disk valves, and if systemic emboli occur, dipyridamole should be added. Patients with atrial fibrillation should be treated prophylactically with coumarin agents, but only if underlying organic heart disease is demonstrable.