Myocardial infarction treated by early ambulation effect of prolonged anticoagulant therapy on the immediate prognosis after discharge from hospital

Abstract

A series of cases reported upon by us earlier in this Journal dealt with the effect of ambulation, which began, on the average, on the sixteenth day of hospitalization, on the results of treatment of myocardial infarction. The results were favorable, except that during the first month after the patients were discharged from the hospital there was a relatively large number of recurrences of infarction (9.3 per cent). Since anticoagulant therapy was discontinued in that previous series at the time the patients were discharged from hospital, we have compared the results with a more recent series from 1957–1959, in which anticoagulant therapy was continued. The series consisted of 321 patients with myocardial infarction. During their ambulation in the hospital, which in these patients was begun, on the average, on the twelfth day of hospitalization, only 1 sudden death and 2 recurrences of infarction were reported; during the first month after the patients were discharged from the hospital there were 8 new infarctions. Thus, in the new series the number of new infarctions during the first month after discharge from the hospital dropped from 9.3 to 2.5 per cent. The difference is highly significant and is probably a result of the continuation of anticoagulant therapy. Results from study of both series of cases clearly indicate that early ambulation is not accompanied by an increased risk to the patient with myocardial infarction.