University of South Dakota Sanford School of Medicine.
Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota.
S D Med. 2024 May;77(5):213-219.
Heart failure (HF) is a common disorder associated with significant morbidity and mortality. It can increase the risk of thromboembolic events, which subsequently lead to increased risk of stroke, ischemic heart disease, thromboembolism, and death. Antithrombotic therapy has been investigated as a potential management strategy for HF patients in sinus rhythm, but its efficacy remains uncertain. Current guidelines do not recommend the routine use of antithrombotics in patients with HF in sinus rhythm without any other indication for their use. Several randomized controlled trials have investigated the efficacy of antithrombotics in HF patients in sinus rhythm. This article provides a concise review of the existing literature to assess the evidence supporting the use of antithrombotics in HF patients in sinus rhythm. The use of warfarin or other anticoagulants has demonstrated a lower risk of stroke but an increased risk of bleeding. The studies demonstrate that anticoagulant therapy in HF patients in sinus rhythm does not provide significant benefits in terms of overall ischemic events or death.
心力衰竭(HF)是一种常见的疾病,与高发病率和死亡率相关。它会增加血栓栓塞事件的风险,进而增加中风、缺血性心脏病、血栓栓塞和死亡的风险。抗血栓治疗已被研究作为窦性心律心力衰竭患者的一种潜在管理策略,但疗效仍不确定。目前的指南不建议在没有其他适应证的情况下常规使用抗血栓药物治疗窦性心律心力衰竭患者。几项随机对照试验已经研究了抗血栓药物在窦性心律心力衰竭患者中的疗效。本文提供了对现有文献的简明回顾,以评估支持在窦性心律心力衰竭患者中使用抗血栓药物的证据。华法林或其他抗凝剂的使用显示出较低的中风风险,但出血风险增加。这些研究表明,窦性心律心力衰竭患者的抗凝治疗在总体缺血事件或死亡方面没有显著获益。