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Should we use anticoagulation for patients with chronic heart failure?

Nature Clinical Practice Cardiovascular Medicine volume 3, pages 580–581 (2006)Cite this article

Whether or not to recommend anticoagulation for patients with chronic heart failure (HF) is a complex decision. There are scant data concerning the incidence of and risk factors for thromboembolism, the efficacy of prophylactic treatment, and the potential for drug–drug interactions. In fact, no adequate data from prospective studies of primary or secondary prevention of thromboembolism in patients with systolic dysfunction without atrial fibrillation (AF) are available to guide this decision.

The incidence of thromboembolic events in the available investigations is poorly defined. In the population-based Framingham Heart Study,1 the relative risk of stroke in individuals with HF was 4.1 for men and 2.8 for women, but many of these individuals had concurrent AF. In HF trials, annual stroke rates between 1.3% and 3.5% have been reported; however, all of these analyses included patients with AF. An analysis by Freudenberger et al. reported thromboembolic rates of only 1% per year in a population of patients in NYHA class II and III without AF.2

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Author information

Authors and Affiliations

  1. Associate Professor of Medicine and Director of the Heart Failure and Transplant Cardiology Program at the Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Ronald S Freudenberger

  2. Mount Sinai School of Medicine,

    Jonathan L Halperin

  3. Zena and Michael A Wiener Cardiovascular Institute at Mount Sinai Medical Center, New York, NY, USA

    Jonathan L Halperin

Authors
  1. Ronald S Freudenberger
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  2. Jonathan L Halperin
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Corresponding author

Correspondence to Ronald S Freudenberger.

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The authors declare no competing financial interests.

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Freudenberger, R., Halperin, J. Should we use anticoagulation for patients with chronic heart failure?. Nat Rev Cardiol 3, 580–581 (2006). https://doi.org/10.1038/ncpcardio0688

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