Adam Oliver, Böhm Michael
Klinik für Innere Medizin III, Kardiologie/Angiologie, Kirrberger Strasse, 66421 Homburg/Saar.
Herz. 2008 Feb;33(1):20-4. doi: 10.1007/s00059-008-3066-8.
The risk of thromboembolic complications is increased in patients with advanced chronic heart failure and severe left ventricular dysfunction. Accepted indications for oral anticoagulation include patients with a history of thromboembolism, concomitant atrial fibrillation, or venous, arterial or cardiac thrombosis. In other subgroups, the benefit of chronic anticoagulation has not been proven and existing data from uncontrolled nonrandomized, mostly retrospective studies and prospective, randomized controlled studies are conflicting. This article summarizes the available data on the thromboembolic risk and the potential benefit of antithrombotic therapy and attempts to provide current orientation and recommendations for anticoagulant therapy in patients with chronic heart failure and severe left ventricular dysfunction.
晚期慢性心力衰竭和严重左心室功能不全患者发生血栓栓塞并发症的风险会增加。口服抗凝治疗的公认适应症包括有血栓栓塞病史、合并心房颤动、或有静脉、动脉或心脏血栓形成的患者。在其他亚组中，长期抗凝治疗的益处尚未得到证实，来自非对照非随机（大多为回顾性研究）以及前瞻性随机对照研究的现有数据相互矛盾。本文总结了关于血栓栓塞风险和抗栓治疗潜在益处的现有数据，并试图为慢性心力衰竭和严重左心室功能不全患者的抗凝治疗提供当前的指导和建议。
