Reduction of Hospital Mortality from Acute Myocardial Infarction by Anticoagulant Therapy

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Abstract
A nationwide study of all 2330 patients hospitalized for a first definite acute myocardial infarction in Israel during a one-year period revealed a significantly lower 21-day mortality rate of patients treated by anticoagulants: 8.3 versus 27.3 per cent in those not receiving such therapy (p < 0.0001). Out of the 22 hospitals studied, the effect was present in 18, absent in two, and not assessable in two. There was a highly significant inverse correlation between the proportion of patients receiving anticoagulant therapy in each hospital and the total 21-day mortality from infarction in that institution (r = -0.57; p < 0.01). The superior survival of patients on anticoagulant therapy did not seem related to differences in age, sex, disease severity, site of infarction, diagnostic criteria or type of hospital. Despite the obvious limitations of retrospective studies the data justify a re-evaluation of the approach to the problem by further investigative effort. (N Engl J Med 292:1359–1362, 1975)