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Anticoagulation in patients with left ventricular systolic dysfunction and sinus rhythm: when?
Nasir Sivri1, Ertan Yetkin2, Gulacan Ozgun Tekin3
1Department of Cardiology, Faculty of Medicine, Trakya University, Edirne, Turkey nasirsivri@hotmail.com.
Summary
Patients with heart failure (HF) face increased stroke risk. This review explores causes and suggests oral anticoagulants may benefit those with LV systolic dysfunction and sinus rhythm, even without prior thromboembolism.
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.
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