In order to approach the anticoagulant controversy from a new direction, we undertook a survey of 239 teaching hospitals worldwide to find out whether physicians were using anticoagulant therapy. It was hoped that such information would add a new perspective to the multitude of controlled and uncontrolled trials and their conflicting results. During late 1974, brief questionnaires were mailed to the directors of coronary care units of 168 American hospitals, 40 British hospitals, and 31 hospitals in other Western European countries. The response rate was 84%, and results from these 201 hospitals, which are presented elsewhere in detail,1 are summarized in this communication.
In the case of acute myocardial infarction (MI), only 28% of the American hospitals administer anticoagulants to most patients (70% to 85%). The remaining 72% anticoagulate either few or no patients, or only 5% to 15% of patients with a high risk of thromboembolic complications. The