{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:27:28Z","timestamp":1781191648935,"version":"3.54.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The contemporary role of prophylactic anticoagulation following extensive anterior wall\n              <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n              \u2010segment myocardial infarction (\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              ) is unclear.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We evaluated anterior\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              patients with left ventricle dysfunction (left ventricular ejection fraction \u226440%) (\u201chigh risk\u201d), categorized by prophylactic warfarin use, within a regional\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              . Patients with pre\u2010existing atrial fibrillation were excluded. The primary outcome was an adjusted (for Global Registry of Acute Coronary Events risk score) 1\u2010year composite of recurrent ischemia, stroke\/transient ischemic attack\/systemic embolism, or all\u2010cause death. Of the 2032\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              admissions, 436 (21.5%) were high risk. After excluding 19 (4.4%) patients with definite left ventricle thrombus and 21 (4.8%) in\u2010hospital deaths (2 had left ventricle thrombus), prophylactic warfarin was utilized in 236\/398 (59.3%) high\u2010risk survivors. Prescriptions were comparable across sex, but recipients were on average younger (58.5\u00a0years versus 64.0\u00a0years,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and lower risk (Global Registry of Acute Coronary Events risk: 163 versus 181,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). No association on the adjusted ischemic composite (23.3% versus 25.3%, odds ratio 0.96, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.60\u20131.55) or thromboembolic events (2.1% versus 1.2%, odds ratio 1.99, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.38\u201310.51) was observed, but reduced 1\u2010year all\u2010cause mortality was noted (2.5% versus 8.6%, odds ratio 0.30, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.11\u20130.81); numerically higher major bleeding was observed at 1\u00a0year (2.5% versus 1.2%, odds ratio 2.17, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.43\u201310.96).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A high utilization of prophylactic warfarin occurs in anterior\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              patients with left ventricle dysfunction, yet appears to provide no additional benefit on the ischemic composite. The association with lower all\u2010cause mortality, but higher bleeding, calls for an improved understanding of its role in high\u2010risk\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.006054","type":"journal-article","created":{"date-parts":[[2017,7,4]],"date-time":"2017-07-04T00:30:19Z","timestamp":1499128219000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Outcomes and Prognostic Impact of Prophylactic Oral Anticoagulation in Anterior ST\u2010Segment Elevation Myocardial Infarction Patients With Left Ventricular Dysfunction"],"prefix":"10.1161","volume":"6","author":[{"given":"Jay S.","family":"Shavadia","sequence":"first","affiliation":[{"name":"University of Alberta, Edmonton, Alberta, Canada"},{"name":"Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada"},{"name":"Duke Clinical Research Institute, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Youngson","sequence":"additional","affiliation":[{"name":"University of Alberta, Edmonton, Alberta, Canada"},{"name":"Alberta Health Services, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin R.","family":"Bainey","sequence":"additional","affiliation":[{"name":"University of Alberta, Edmonton, Alberta, Canada"},{"name":"Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Bakal","sequence":"additional","affiliation":[{"name":"University of Alberta, Edmonton, Alberta, Canada"},{"name":"Alberta Health Services, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Welsh","sequence":"additional","affiliation":[{"name":"University of Alberta, Edmonton, Alberta, Canada"},{"name":"Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.019"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs215"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a014875"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.03.020"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCA.0000000000000032"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.07.018"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.115.003417"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.073"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(03)00972-X"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.1556"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.05.062"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62177-1"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH12-08-0578"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.03.022"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00804-4"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.10.005"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.100912"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00599-4"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198308113090602"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.08.067"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(88)91517-3"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.73.5.885"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.113.000644"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-015-1252-0"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(89)90592-5"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198108063050601"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2012.06.029"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22450"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e318142be20"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.12.006"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-03-0954"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112277"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.027"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.117.006054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:32:03Z","timestamp":1715596323000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.117.006054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":33,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1161\/JAHA.117.006054"],"URL":"https:\/\/doi.org\/10.1161\/jaha.117.006054","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]},"assertion":[{"value":"2017-03-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e006054"}}