Lee I. Blecher, MD

Compared with aspirin alone, aspirin plus warfarin (goal for international normalized ratio, 2–2.5) or warfarin alone (goal for international normalized ratio, 2.8–4.3) results in fewer reinfarctions and thromboembolic events.

Treating 1000 patients for 1 year would result in approximately 10 fewer reinfarctions and 3 fewer strokes at a cost of 4 more major bleeding episodes. In addition, many patients will not be able to tolerate warfarin therapy. For highly motivated patients at low risk of bleeding, warfarin or warfarin plus aspirin is more effective than aspirin for secondary prevention of myocardial infarction.

Compared with aspirin alone, aspirin plus warfarin (goal for international normalized ratio, 2–2.5) or warfarin alone (goal for international normalized ratio, 2.8–4.3) results in fewer reinfarctions and thromboembolic events.

Treating 1000 patients for 1 year would result in approximately 10 fewer reinfarctions and 3 fewer strokes at a cost of 4 more major bleeding episodes. In addition, many patients will not be able to tolerate warfarin therapy. For highly motivated patients at low risk of bleeding, warfarin or warfarin plus aspirin is more effective than aspirin for secondary prevention of myocardial infarction.

Compared with aspirin alone, aspirin plus warfarin (goal for international normalized ratio, 2–2.5) or warfarin alone (goal for international normalized ratio, 2.8–4.3) results in fewer reinfarctions and thromboembolic events.

Treating 1000 patients for 1 year would result in approximately 10 fewer reinfarctions and 3 fewer strokes at a cost of 4 more major bleeding episodes. In addition, many patients will not be able to tolerate warfarin therapy. For highly motivated patients at low risk of bleeding, warfarin or warfarin plus aspirin is more effective than aspirin for secondary prevention of myocardial infarction.