MANAGEMENT OF THROMBOSIS IN CORONARY HEART-DISEASE

Management of thrombosis in coronary heart disease comprises the manag ement of acute coronary thrombosis presenting as myocardial infarction or as unstable angina, the use of anticoagulant therapy to prevent or treat complications of myocardial infarction, and prophylaxis in pati ents identified as being at increased risk. Thrombolytic therapy and a spirin independently and additively reduce mortaility in evolving myoc ardial infarction. Aspirin and heparin, but not thombolytic agents, im prove outcome in unstable angina. Heparin and warfarin reduce the risk of embolism from left ventricular thrombus forming post-infarction. A spirin has been shown to reduce the risk of further cardiovascular eve nts or cardiac death in patients identified as at high risk. Current r esearch is evaluating the role of antithrombins and platelet adhesion inhibitors as adjuvant therapy after thrombolysis, in unstable angina, and as heparin substitutes during coronary angioplasty, and of low do se warfarin as long-term prophylaxis in high risk patients.