Stanford Wessler

Clinical Implications of Heparin

The one clinical use for heparin (among the many suggested) that has remained unchallenged for the last quarter-century is its potential effectiveness as an antithrombotic agent.

Anticoagulant Therapy in Coronary Artery Disease

Information available at the present time allows the following conclusions to be drawn:1. Anticoagulant therapy is clearly effective in treating and preventing venous thrombosis and pulmonary emboli.2. If used in the treatment of acute myocardial infarction, anticoagulant drugs may salvage 3 to 4% of the treated population. This small gain is probably achieved by the prevention of thromboembolic episodes. While only a small percentage of patients are benefited, the actual number of persons salvaged is relatively great because of the large size of the population at risk. In the considerable majority of treated patients who do not benefit from coumarin drugs, the therapy need do no harm, if proper safeguards are employed in the selection of patients and the administration and laboratory control of the drug.3. In long-term therapy of patients who have recovered from acute myocardial infarction, it appears that men, especially below age 60, may be helped for the first 1 or 2 years after infarction.4. More data are required to evaluate the role of anticoagulant treatment in patients with angina pectoris or coronary insufficiency. For the present, the physician may reasonably be influenced in the use of anticoagulant therapy by the recent onset of symptoms, the patients age, and the family history.5. Although appropriately controlled studies are lacking, it appears as though patients with peripheral emboli secondary to coronary artery disease may be benefited by anticoagulant therapy.