ASPIRIN PLUS EITHER DIPYRIDAMOLE OR TICLOPIDINE IS EFFECTIVE IN PREVENTING RECURRENT MYOCARDIAL-INFARCTION

The efficacy of combining antiplatelet agents with low doses of aspiri n to prevent cardiac events in patients with myocardial infarction was examined. A total of 1,083 patients with prior myocardial infarction were randomly divided into those who were (618) and were not (465) tre ated with antiplatelet agents, and observed for 12.5+/-18.5 months. Th ose treated with antiplatelet agents included 113 patients treated wit h aspirin (50 mg) plus dipyridamole (150 mg/day), 253 treated with asp irin (50 mg) plus ticlopidine (200 mg/day), and 252 treated with only 1 of the 3 antiplatelet agents. Cardiac events, including fatal or non fatal recurrent myocardial infarction, death by congestive heart failu re, and sudden death, occurred in 34 patients (7.3%) in the nontreatme nt group and in 19 patients (3.1%: p<0.01) in the treatment group; odd s ratio 0.40, 95% confidence interval 0.23-0.71. There were only 2 car diac events (1.8%) in the aspirin+dipyridamole group (p<0.05 vs nontre atment group: odds ratio 0.28: 0.08-1.03), and 5 such events(2.0%) in the aspirin+ticlopidine group (p<0.01: odds ratio 0.28: 0.11-0.69). Su bgroup analysis to exclude differences in the patients' background con firmed the efficacy of these antiplatelet agents. We conclude that com bined treatment with low doses of aspirin plus either dipyridamole or ticlopidine is effective in preventing cardiac events in patients who have had prior myocardial infarction.