Effect of fixed low-dose warfarin added to aspirin in the long term after acute myocardial infarction the LoWASA Study
(2004) In European Heart Journal 25(3). p.232-239- Abstract
- Aim To evaluate whether Long-term treatment with a fixed tow dose of warfarin in combination with aspirin improves the prognosis compared with aspirin treatment alone after an acute myocardial infarction (AMI). Methods Patients who were hospitalized for AMI were randomized to either 1.25 mg of warfarin plus 75 mg of aspirin (n=1659) daily or 75 mg of aspirin atone (n=1641). The study was performed according to the PROBE (Prospective Open Treatment and Blinded End Point Evaluation) design and was conducted at 31 hospitals in Sweden. The median follow-up time was 5.0 years. In the aspirin+warfarin group, 30.2% were permanently withdrawn as opposed to 14.0% in the aspirin group (P<0.0001). Analyses were performed on an intention-to-treat... (More)
- Aim To evaluate whether Long-term treatment with a fixed tow dose of warfarin in combination with aspirin improves the prognosis compared with aspirin treatment alone after an acute myocardial infarction (AMI). Methods Patients who were hospitalized for AMI were randomized to either 1.25 mg of warfarin plus 75 mg of aspirin (n=1659) daily or 75 mg of aspirin atone (n=1641). The study was performed according to the PROBE (Prospective Open Treatment and Blinded End Point Evaluation) design and was conducted at 31 hospitals in Sweden. The median follow-up time was 5.0 years. In the aspirin+warfarin group, 30.2% were permanently withdrawn as opposed to 14.0% in the aspirin group (P<0.0001). Analyses were performed on an intention-to-treat basis. Results The combination of cardiovascular death, reinfarction or stroke was registered in 28.1% in the aspirin+warfarin group versus 28.8% in the aspirin group (NS). Cardiovascular deaths occurred in 14.2% in the aspirin+warfarin group vs 15.7% in the aspirin group (NS). Whereas no difference was found with regard to total mortality or reinfarction, those randomized to aspirin+warfarin had a reduced occurrence of stroke (4.7% vs 7.1%; P=0.004). The percentage of patients who suffered a serious bleed was 1.0% in the aspirin group vs 2.2% in the combination group (P=0.0006). Conclusion A fixed tow dose of warfarin added to aspirin in the Long term after AMI did not reduce the combined risk of cardiovascular death, reinfarction or stroke. The results did, however, indicate that a fixed low dose of warfarin added to aspirin reduced the risk of stroke, but this was a secondary end point. The combination of aspirin and warfarin was associated with an increased risk of bleeding. (C) 2003 Published by Elsevier Ltd on behalf of The European Society of Cardiology. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/899308
- author
- Herlitz, J ; Holm, Johan LU ; Peterson, M ; Karlson, BW ; Evander, MH and Erhardt, Leif RW LU
- organization
- publishing date
- 2004
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- acute myocardial, infarction, warfarin, prognosis
- in
- European Heart Journal
- volume
- 25
- issue
- 3
- pages
- 232 - 239
- publisher
- Oxford University Press
- external identifiers
-
- pmid:14972424
- wos:000189263900009
- scopus:1242294440
- ISSN
- 1522-9645
- DOI
- 10.1016/j.ehj.2003.10.026
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Cardiology (013242100), Emergency medicine/Medicine/Surgery (013240200)
- id
- 6f264454-ab46-436a-bddd-647fe04c2399 (old id 899308)
- date added to LUP
- 2016-04-01 15:58:48
- date last changed
- 2022-01-28 08:27:54
@article{6f264454-ab46-436a-bddd-647fe04c2399, abstract = {{Aim To evaluate whether Long-term treatment with a fixed tow dose of warfarin in combination with aspirin improves the prognosis compared with aspirin treatment alone after an acute myocardial infarction (AMI). Methods Patients who were hospitalized for AMI were randomized to either 1.25 mg of warfarin plus 75 mg of aspirin (n=1659) daily or 75 mg of aspirin atone (n=1641). The study was performed according to the PROBE (Prospective Open Treatment and Blinded End Point Evaluation) design and was conducted at 31 hospitals in Sweden. The median follow-up time was 5.0 years. In the aspirin+warfarin group, 30.2% were permanently withdrawn as opposed to 14.0% in the aspirin group (P<0.0001). Analyses were performed on an intention-to-treat basis. Results The combination of cardiovascular death, reinfarction or stroke was registered in 28.1% in the aspirin+warfarin group versus 28.8% in the aspirin group (NS). Cardiovascular deaths occurred in 14.2% in the aspirin+warfarin group vs 15.7% in the aspirin group (NS). Whereas no difference was found with regard to total mortality or reinfarction, those randomized to aspirin+warfarin had a reduced occurrence of stroke (4.7% vs 7.1%; P=0.004). The percentage of patients who suffered a serious bleed was 1.0% in the aspirin group vs 2.2% in the combination group (P=0.0006). Conclusion A fixed tow dose of warfarin added to aspirin in the Long term after AMI did not reduce the combined risk of cardiovascular death, reinfarction or stroke. The results did, however, indicate that a fixed low dose of warfarin added to aspirin reduced the risk of stroke, but this was a secondary end point. The combination of aspirin and warfarin was associated with an increased risk of bleeding. (C) 2003 Published by Elsevier Ltd on behalf of The European Society of Cardiology.}}, author = {{Herlitz, J and Holm, Johan and Peterson, M and Karlson, BW and Evander, MH and Erhardt, Leif RW}}, issn = {{1522-9645}}, keywords = {{acute myocardial; infarction; warfarin; prognosis}}, language = {{eng}}, number = {{3}}, pages = {{232--239}}, publisher = {{Oxford University Press}}, series = {{European Heart Journal}}, title = {{Effect of fixed low-dose warfarin added to aspirin in the long term after acute myocardial infarction the LoWASA Study}}, url = {{http://dx.doi.org/10.1016/j.ehj.2003.10.026}}, doi = {{10.1016/j.ehj.2003.10.026}}, volume = {{25}}, year = {{2004}}, }