EXPERIENCE WITH THE ANTICOAGULANT, MARCUMAR

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Abstract
Since 1943 over 25,000 patients have received anticoagulant therapy in this clinic. This report comprises 1729 patients treated since June, 1955 with the investigational drug, phenprocoumon (Marcumar). Because certain types of hospital cases present individual difficulties and therapeutic problems, they are classified and discussed under heading of (1) coronary thrombosis, (2) phlebitis, (3) postoperative prophylaxis and (4) post partum prophylaxis. Actual dosage schedules with resulting type of prothrombin curve in each case is cited. A comparison of Marcumar with other anticoagulants used in 288 long term coronary outpatients is given, especially observing types of response from Dicumarol, Cumopyran and Marcumar. While the so called short -acting anticoagulants, such as Hedulin and Dipaxin, obtained a quicker therapeutic level, difficulties were encountered by their tendency to give "peak and valley" type of prothrombin curve. However, any case requiring urgent anticoagulation requires heparin rather than short acting anticoagulants. With the longer acting Marcumar any threatening rise in prothrombin time is guarded against by judicious use, if necessary, of minimal oral doses of K1, even as low as 1.75 mgs. There was no death due to hemorrhage in the entire series. In 91 "postoperative bowel, stomach and gall bladder cases", known for their liability to anticoagulant hemorrhage cautious treatment resulted in one hemorrage, easily controlled and with no instance of thrombo-embolism. In 400 routine postoperative cases 3 patients had minimal hemorrhage and there was no bleeding in 1080 coronary, phlebitis and post partum cases. In all types of cases Marcumar consistently gave more stable and satisfactory prothrombin curves than other anticoagulants used by us.