ANTICOGULATE OR NOT TO ANTICOGULATE PATIENTS WITH CARDIOMYOPATHY

摘要: The current published literature does not indicate whether the long-term effect of anticoagulant or antiplatelet therapy contributes to mortality reduction in patients with LV dysfunction. Evaluating for personal risk emboli ischemic coronary artery events may influence choice therapies. As more is learned about mechanisms drug effects different populations, physicians be better able direct appropriate Until that time, one must weigh risks and benefits each alone combination. In NYHA class IV patients, thrombosis owing spontaneous clotting increases as adverse potential warfarin inhibiting prostaglandin mediated vasodilation by aspirin. I II quality life convenience multidrug weighed against devastating a major stroke. less symptomatic acute higher than previously identified. This would suggest all depressed function should on some type therapy. WATCH study will provide much needed information outcome differences between these agents. Conclusions based available data include following: Heart failure increasing incidence prevalence. Atherosclerotic disease an important causative factor development heart comorbid condition patients. There measurable rate stroke failure, although cause death large studies often sudden progressive failure. Sudden from new events, asystole, ventricular tachyarrhythmias. strokes are cardioembolic origin. increased EF worsens functional declines. interactions aspirin ACE inhibitors have been best evaluated hemodynamic effects. additional factors hitherto studied. classes III Warfarin use has clear indications atrial fibrillation mechanical prosthetic valves, hypercoagulable states, previous history embolization. Aspirin inexpensive commonly available, but its articulated prescribing physician. multicenter prospective trials guidance this subject. ongoing do placebo arm, however, indicating consensus among clinicians cardiomyopathy until further emerge.