At present , there are no data on the role of oral anticoagulation versus antiplatelet agents in heart failure with preserved ejection fraction with sinus rhythm .
Also , there were no data from RCTs on the utility of non-vitamin K antagonist oral anticoagulants compared to antiplatelet agents in heart failure with sinus rhythm
BACKGROUND Morbidity in patients with chronic heart failure is high , and this predisposes them to thrombotic complications , including stroke and thromboembolism , which in turn contribute to high mortality .
Oral anticoagulants ( e.g. warfarin ) and antiplatelet agents ( e.g. aspirin ) are the principle oral antithrombotic agents .
Many heart failure patients with sinus rhythm take aspirin because coronary artery disease is the leading cause of heart failure .
Oral anticoagulants have become a st and ard in the management of heart failure with atrial fibrillation .
However , a question remains regarding the appropriateness of oral anticoagulants in heart failure with sinus rhythm .
This up date of a review previously published in 2012 aims to address this question .
OBJECTIVES To assess the effects of oral anticoagulant therapy versus antiplatelet agents for all-cause mortality , non-fatal cardiovascular events and risk of major bleeding in adults with heart failure ( either with reduced or preserved ejection fraction ) who are in sinus rhythm .
Antiplatelet agents and survival: a cohort analysis from the Studies of Left Ventricular Dysfunction (SOLVD) trial.
OBJECTIVES This study sought to evaluate the relation between antiplatelet agent ( APA ) use and survival and morbidity from cardiac disease in patients with left ventricular ( LV ) systolic dysfunction . BACKGROUND APAs play an important role in the prevention and treatment of coronary disease . Their effects in patients with LV systolic dysfunction are unknown . METHODS We review ed data on  APA use in 6,797 patients enrolled in the Studies of Left Ventricular Dysfunction ( SOLVD ) trial and analyzed the relation between their use and all-cause mortality as well as the combined end point of death or hospital admission for heart failure ( HF ) . We used Cox regression to adjust for differences in baseline characteristics and to test for the interaction between APA use and selected patient variables in relation to outcome . RESULTS APA use ( 46.3 % of patients ) was associated with significantly reduced mortality from all causes ( adjusted hazard ratio [ HR ] 0.82 , 95 % confidence interval [ CI ] 0.73 to 0.92 , p = 0.0005 ) and reduced risk of death or hospital admission for HF ( adjusted HR 0.81 , 95 % CI 0.74 to 0.89 , p < 0.0001 ) but was not influenced by trial assignment , gender , LV ejection fraction , New York Heart Association class or etiology . A strong interaction was observed among  APA use , r and omization group and all-cause mortality . The association between APA use and survival was not observed in the enalapril group , nor was an enalapril benefit on survival detectable in patients receiving APAs at baseline . However , r and omization to enalapril therapy significantly reduced the combined end point of death or hospital admission for HF in APA users . CONCLUSIONS In patients with LV systolic dysfunction , use of APAs is associated with improved survival and reduced morbidity . This association is retained after adjustment for baseline characteristics . APA use is associated with retained but reduced benefit from enalapril
At present , there are no data on the role of oral anticoagulation versus antiplatelet agents in heart failure with preserved ejection fraction with sinus rhythm .
Also , there were no data from RCTs on the utility of non-vitamin K antagonist oral anticoagulants compared to antiplatelet agents in heart failure with sinus rhythm
BACKGROUND Morbidity in patients with chronic heart failure is high , and this predisposes them to thrombotic complications , including stroke and thromboembolism , which in turn contribute to high mortality .
Oral anticoagulants ( e.g. warfarin ) and antiplatelet agents ( e.g. aspirin ) are the principle oral antithrombotic agents .
Many heart failure patients with sinus rhythm take aspirin because coronary artery disease is the leading cause of heart failure .
Oral anticoagulants have become a st and ard in the management of heart failure with atrial fibrillation .
However , a question remains regarding the appropriateness of oral anticoagulants in heart failure with sinus rhythm .
This up date of a review previously published in 2012 aims to address this question .
OBJECTIVES To assess the effects of oral anticoagulant therapy versus antiplatelet agents for all-cause mortality , non-fatal cardiovascular events and risk of major bleeding in adults with heart failure ( either with reduced or preserved ejection fraction ) who are in sinus rhythm .