Optimal antithrombotic management of anticoagulated patients with a history of myocardial infarction

A common clinical dilemma exists for optimal antithrombotic management of a patient requiring oral anticoagulation (such as venous thromboembolism) and continued secondary myocardial infarction prophylaxis. Often aspirin will be continued concomitantly with the indicated oral anticoagulation therapy; however, additional benefits and increased risks of this practice have not been established. A systematic literature review was conducted to determine the benefits and risks of antithrombotic treatment strategies. Five clinical trials met the inclusion criteria and were evaluated to answer this clinical question.