Management of Heart Failure: IV. Anticoagulation for Patients With Heart Failure Due to Left Ventricular Systolic Dysfunction

摘要: Objective. —This article reviews the incidence of arterial thromboembolism in patients with heart failure who are not receiving anticoagulants. We also examine whether more severe ventricular dysfunction increases this and efficacy risks anticoagulation for sinus rhythm. Data Sources. —English-language studies referenced MEDLINE or EMBASE (January 1966 to September 1993) were reviewed. used search terms failure, congestive; congestive failure; cardiac ; dilated cardiomyopathy conjunction anticoagulation, cerebrovascular disorders, stroke , . Study Selection. —All separate data chronic anticoagulants included. Articles addressing valvular disease secondary acute myocardial infarction Chagas' excluded. Studies occurrence left mural thrombi Extraction Synthesis. —Inclusion exclusion criteria, prevalence atrial fibrillation, mean follow-up, thromboembolic events extracted. If was given, estimated using proportion divided by follow-up. Conclusion. —The ranged from 0.9 5.5 per 100 patient-years, largest reporting 2.0% 2.4%. Findings regarding relationship between function contradictory. No controlled trial has assessed rhythm, reported case series 0% 100%. Until adequate performed, should be discouraged ( JAMA 1994;272:1614-1618)