ASPIRIN VERSUS COUMADIN IN THE PREVENTION OF REOCCLUSION AND RECURRENT ISCHEMIA AFTER SUCCESSFUL THROMBOLYSIS - A PROSPECTIVE PLACEBO-CONTROLLED ANGIOGRAPHIC STUDY - RESULTS OF THE APRICOT STUDY

Background. Successful coronary thrombolysis involves a risk for reocclusion that cannot be prevented by invasive strategies. Therefore, we studied the effects of three antithrombotic regimens on the angiographic and clinical courses after successful thrombolysis.

Methods and Results. Patients treated with intravenous thrombolytic therapy followed by intravenous heparin were eligible when a patent infarct-related artery was demonstrated at angiography

Conclusions. At 3 months after successful thrombolysis, reocclusion occurred in about 30% of patients, regardless of the use of antithrombotics. Compared with placebo, aspirin significantly reduces reinfarction rate and revascularization rate, improves event-free survival, and better preserves left ventricular function. The efficacy of Coumadin on these end points appears less than that of aspirin. The still-high reocclusion rate emphasizes the need for better antithrombotic therapy in these patients.