Anticoagulation in Patients with Heart Failure and Sinus Rhythm

Int Heart J. 2020 Nov 28;61(6):1204-1211. doi: 10.1536/ihj.20-248. Epub 2020 Nov 13.

Abstract

The risk of thromboembolic events is significantly increased among patients with heart failure, even in those without atrial fibrillation. However, it is still unclear whether patients with heart failure and sinus rhythm can benefit from prophylactic anticoagulant therapy.This was a retrospective review of the pathophysiological mechanisms, epidemiological studies, and clinical trials on anticoagulation in patients with heart failure and sinus rhythm.Some subgroup analyses of clinical trials found that prophylactic anticoagulant therapy could reduce the incidence of stroke in patients with heart failure and sinus rhythm, and the risk of bleeding was significantly increased. Regarding the incidence of primary endpoint outcomes, all results from clinical trials were negative.Prophylactic anticoagulation did not improve the clinical outcome in patients with heart failure and sinus rhythm.

Keywords: Dabigatran; Rivaroxaban; Warfarin.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • Factor Xa Inhibitors / therapeutic use
  • Heart Failure / blood
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Heart Failure / physiopathology
  • Hemorrhage / chemically induced
  • Hemorrhage / epidemiology
  • Humans
  • Stroke / blood
  • Stroke / epidemiology
  • Stroke / physiopathology
  • Stroke / prevention & control*
  • Thromboembolism / blood
  • Thromboembolism / epidemiology
  • Thromboembolism / physiopathology
  • Thromboembolism / prevention & control*

Substances

  • Anticoagulants
  • Factor Xa Inhibitors