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Efficacy of antithrombotic therapy in chronic heart failure: the HELAS study

Dennis V Cokkinos1, George C Haralabopoulos, John B Kostis

  • 1Cardiology Department, Hippokrateio Hospital, University of Athens, Athens, Greece.

European Journal of Heart Failure
|June 2, 2006
PubMed

Insights

Long-term antithrombotic treatment did not significantly reduce thromboembolism in chronic heart failure patients. Embolic events were rare, and outcomes were similar across treatment groups in the HELAS study.

Area of Science:

  • Cardiology
  • Thrombosis Research
  • Clinical Trials

Background:

  • The efficacy of long-term antithrombotic therapy in preventing thromboembolism in chronic heart failure (CHF) remains uncertain.
  • The Heart failure Long-term Antithrombotic Study (HELAS) aimed to clarify this by evaluating antithrombotic treatments in CHF patients.

Purpose of the Study:

  • To assess the impact of antithrombotic treatment on thromboembolic events in patients with chronic heart failure.
  • To evaluate the effect of aspirin and warfarin on clinical outcomes and echocardiographic parameters in CHF.

Main Methods:

  • A multicentre, randomized, double-blind, placebo-controlled trial involving 197 patients with CHF (ejection fraction <35%).
  • Patients with Ischemic Heart Disease received aspirin or warfarin; those with Dilated Cardiomyopathy (DCM) received warfarin or placebo.

Main Results:

  • Analysis of 312 patient-years revealed an embolic event rate of 2.2 per 100 patient-years, with no significant differences between treatment groups.
  • No significant differences were observed in myocardial infarction, hospitalization, heart failure exacerbation, death, or hemorrhage rates.
  • A significant increase in left ventricular ejection fraction was noted in DCM patients treated with warfarin over 2 years.

Conclusions:

  • Embolic events are infrequent in heart failure patients, irrespective of antithrombotic treatment.
  • Current antithrombotic strategies do not appear to significantly alter the overall outcomes in this patient population.
Abstract

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