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Atrial Fibrillation in Heart Failure: Focus on Antithrombotic Management

Mohammed Obeidat1, Malcolm Burgess1, Gregory Y H Lip2

  • 1Department of Cardiology, Aintree Hospital, Liverpool, UK.

Cardiology Clinics
|April 25, 2022
PubMed

Insights

Patients with heart failure (HF) and atrial fibrillation (AF) face increased risks. Anticoagulation is recommended, with non-vitamin K antagonists showing effectiveness and safety.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Pharmacology

Background:

  • Heart failure (HF) and atrial fibrillation (AF) are prevalent in aging populations.
  • These conditions frequently coexist and are interconnected.
  • Their combined presence significantly elevates morbidity and mortality.

Purpose of the Study:

  • To explore the relationship between AF and HF.
  • To investigate the thromboembolic risks associated with concurrent AF and HF.
  • To evaluate anticoagulation strategies for patients with both conditions.

Main Methods:

  • Literature review of studies on AF and HF.
  • Analysis of stroke risks in patients with AF and HF subtypes.
  • Comparison of anticoagulation therapies, including warfarin and non-vitamin K antagonists.

Main Results:

  • Significant stroke risks are present in patients with AF and all HF subtypes.
  • Morbidity and mortality rates increase when AF and HF occur together.
  • Non-vitamin K antagonist oral anticoagulants demonstrate comparable safety and efficacy to warfarin.

Conclusions:

  • All patients with coexisting AF and HF should be considered for anticoagulation therapy.
  • Non-vitamin K antagonists represent a safe and effective option for anticoagulation in this patient group.
  • Effective management of AF and HF is crucial for reducing thromboembolic events and improving patient outcomes.

Keywords:
AnticoagulationAtrial fibrillationDirect oral anticoagulantHeart failureNOAC

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