Anticoagulation in patients with left ventricular systolic dysfunction and sinus rhythm: when?

Area of Science:

• Cardiology
• Neurology
• Internal Medicine

Background:

• Left ventricular (LV) systolic dysfunction and chronic heart failure (HF) increase the risk of intraventricular thrombus formation and stroke.
• Current guidelines recommend oral anticoagulants for patients with atrial fibrillation and a history of thromboembolism.
• Anticoagulant use in patients with LV systolic dysfunction, sinus rhythm, and no prior thromboembolism remains controversial.

Purpose of the Study:

• To investigate the reasons for increased stroke rates in patients shortly after HF diagnosis.
• To propose a rationale for using oral anticoagulants in specific HF patient groups.

Main Methods:

• Literature review of epidemiologic data and clinical guidelines.
• Analysis of factors contributing to stroke risk in systolic HF patients.

Main Results:

• Recent data indicate a higher incidence of stroke in systolic HF patients soon after diagnosis.
• The review identifies potential mechanisms linking HF and stroke risk.

Conclusions:

• Further research is needed to clarify the benefits of anticoagulation in HF patients with LV systolic dysfunction and sinus rhythm.
• A potential rationale exists for considering oral anticoagulants in select HF patients to mitigate stroke risk.