The Prophylactic Value of Long-Term Anticoagulant Therapy

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Abstract
The incidence of first non-fatal recurrence after a thromboembolic episode was studied in a group of 308 private patients maintained on continuous anticoagulant therapy for periods of from 1 month to 10 years. The group included patients with coronary, cerebrovascular and venous and peripheral arterial thromboembolic disease. The recurrence pattern in this group was compared with that in 203 of the above cases who were observed for periods of less than 1 to over 7 years after discontinuing continuous therapy. The results, in survivorship table form, reveal that an estimated 821 per 1000 in the treated group would be free of recurrence after 60 months of continuous therapy, as compared with 396 per 1000 free of recurrence 60 months after having discontinued therapy. This difference is shown to be statistically significant at the 5% level. The recurrence rate after discontinuance is higher in patients whose intitial period of treatment was more prolonged, indicating that treatment forestalls thromboembolic complications, but does not always arrest the underlying disease process.

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