Coumadin Aspirin Reinfarction Study: Rationale and Design of the CARS Study.

Acute myocardial infarction remains the leading cause of death in the United States. Following increased recognition of the role of thrombosis in the pathogenesis of myocardial infarction, both antiplatelet and anticoagulant therapy have been proven effective in preventing recurrent infarction. However, the optimal antithrombotic regimen remains undetermined. In particular, the role of combination antithrombotic therapy has not been studied. The Coumadin Aspirin Reinfarction Study (CARS) will compare the safety and efficacy of fixed-dose combination Coumadin plus aspirin versus aspirin alone among 8000 survivors of acute myocardial infarction. Patients will be followed for up to 4 years. CARS will provide important information regarding the optimal antithrombotic regimen for myocardial infarct survivors.