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John A. Cairns, MD, FRCPC; Barbara A. Markham, MBA

JAMA. 1995;273(12):965-967.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Long-term antithrombotic therapy with oral anticoagulants or antiplatelet agents for survivors of acute myocardial infarction (AMI) is widely prescribed and has been evaluated in many clinical trials.¹ An overview in 1970² suggested a modest benefit of anticoagulation therapy, but—although oral anticoagulants have been widely used in some European countries—their use in North America is limited. More recently, the Sixty Plus,³ Warfarin Re-infarct Study,⁴ and the Anticoagulants in the Secondary Prevention of Events in Coronary Thrombosis (ASPECT)⁵ trials have all shown statistically significant reductions of clinically important vascular outcomes by anticoagulant treatment compared with placebo.

See also p 925.

In this issue of JAMA, van Bergen et al⁶ report on an economic analysis of anticoagulant treatment in the Netherlands that exemplifies the rather unusual win-win situation of increased efficacy and reduced cost. The ASPECT study randomized 3404 patients within 6 weeks of their AMIs to . . . [Full Text PDF of this Article]

Author Affiliations
From the Departments of Medicine (Dr Cairns), Clinical Epidemiology and Biostatistics (Dr Cairns and Ms Markham), and the Centre for Health Economics and Policy Analysis (Ms Markham), McMaster University, Hamilton, Ontario.

Footnotes
Reprint requests to Department of Medicine, Room 3W10, McMaster University Medical Centre, 1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5 (Dr Cairns).

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