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The science of preventing infective endocarditis in patients with valvular heart disease is evolving. Studies during the past two decades have shown that many old practices are not worthwhile (such as giving antibiotics liberally for most dental procedures), yet no better techniques have emerged.
Swiss researchers used a rat model of endocarditis to study the effects of antiplatelet drugs and anticoagulants on development of endocarditis caused by two common gram-positive organisms: an oral streptococcus strain and Staphylococcus aureus. Neither aspirin nor the antiplatelet drug ticlopidine by itself was effective; the warfarin-like vitamin K antagonist acenocoumarol was similarly ineffective. However, a combination of aspirin and ticlopidin…