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Thromboembolism and antithrombotic therapy in congestive heart failure
1Cardilogy Section 111C, Veterans Affairs Medical Center, Philadephia, PA 19104, USA.
Insights
Patients with heart failure have a significant risk of thromboembolic events. Anticoagulant therapy
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Thromboembolic events occur in 1.6-3.5% of patients with class II-III congestive heart failure annually.
- Limited exercise capacity and left ventricular thrombus are risk factors for thromboembolism.
Purpose of the Study:
- To review the current understanding of thromboembolism risk in congestive heart failure.
- To evaluate the efficacy and safety of anticoagulant therapy in this patient population.
Main Methods:
- Literature review of studies on thromboembolism in congestive heart failure.
- Analysis of existing data on anticoagulant therapy outcomes.
Main Results:
- Anticoagulant therapy has not consistently eliminated thromboembolism.
- Controlled studies on the benefits and risks are lacking.
Conclusions:
- Evidence is insufficient to make definitive recommendations for anticoagulant therapy.
- Further controlled studies are needed to guide treatment decisions.
Abstract:
The incidence of thromboembolic events in unselected patients with class II-III congestive heart failure is 1.6-3.5% per year. Marked limitation of exercise capacity and the presence of echocardiographic left ventricular thrombus appear to be associated with an increased risk of thromboembolism. Several studies have reported that anticoagulant therapy does not eliminate the occurrence of thromboembolism. Because the benefit and risks of anticoagulant therapy in patients with congestive heart failure have not been examined in controlled studies, it is difficult to make well-founded recommendations.