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2015 ; 8
(1
): 1250
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Anticoagulation in Heart Failure: a Review
#MMPMID27957180
Zeitler EP
; Eapen ZJ
J Atr Fibrillation
2015[Jun]; 8
(1
): 1250
PMID27957180
show ga
Heart failure (HF) with reduced left ventricular function inflicts a large and
growing burden of morbidity and mortality in the US and across the globe. One
source of this burden is stroke. While it appears that HF itself may impose some
risk of stroke, it is in the presence of other risk factors, like atrial
fibrillation, that the greatest risks are observed. Therapeutic anticoagulation
is the mainstay of risk reduction strategies in this population. While warfarin
was the only available therapy for anticoagulation for many decades, there are
now four direct oral anticoagulants available. In three of these four, outcomes
in the specific subgroup of patients with heart failure have been examined. In
this review, we provide some pathophysiologic basis for the risk of stroke in
heart failure. In addition, the available therapeutic options for stroke risk
prevention in heart failure are described in detail including how these options
are incorporated into relevant professional society guidelines.