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Anticoagulation therapy in patients with heart failure due to systolic dysfunction and sinus rhythm: analysis of REDINSCOR registry.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Avellana, Patricia Segovia, Javier Ferrero, Andreu Vazquez, Rafael Brugada, Josep Borràs, Xavier Alonso-Pulpón, Luis Antonio Cinca, Juan |
| Copyright Year | 2012 |
| Abstract | INTRODUCTION AND OBJECTIVES In patients with heart failure, left ventricular ejection fraction ≤35% and sinus rhythm without conditions such as atrial fibrillation, thrombus or history of thromboembolic events, the use of anticoagulation is controversial. Our objective was to evaluate the anticoagulation strategy in these patients, variables associated with its use, and its effects on various cardiovascular events. METHODS Of the patients included in the REDINSCOR registry with left ventricular ejection fraction ≤35% and sinus rhythm without other anticoagulation indications (including patients with heart failure from 19 Spanish centres), we compared those who received this treatment with the remaining patients. RESULTS Between 2007 and 2010, 2263 patients were included, of whom 902 had left ventricular ejection fraction ≤35% and sinus rhythm. Of these, 237 (26%) were receiving anticoagulation therapy. Variables associated with this treatment were a lower left ventricular ejection fraction, ischemic etiology, advanced functional class, wider QRS, larger left atrial diameter, and hospitalization. After 21(11-32) months of median follow-up, there were no significant differences in total mortality (14% versus 12.5%) or stroke (0.8% versus 0.9%). A propensity score adjusted multivariate analysis showed a reduction in a combined end-point including cardiac death, heart transplantation, coronary revascularization, and cardiovascular hospitalization (hazard ratio: 0.74; 95% confidence interval, 0.56-0.97; P=.03) in patients receiving anticoagulation therapy. No information regarding bleeding was collected in the follow-up. CONCLUSIONS In a large and contemporary series of patients with heart failure, left ventricular ejection fraction ≤35% and sinus rhythm, 26% received anticoagulation therapy. This was not associated with lower mortality or stroke incidence, although there was a reduction in major cardiac events. |
| Starting Page | 1 |
| Ending Page | 7 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://appswl.elsevier.es/watermark/ctl_servlet?_f=10&accion=L&anuncioPdf=ERROR_publi_pdf&fichero=255v65n08a90147895pdf001.pdf&lan=en&origen=cardio&pcontactid=&pident_articulo=90147895&pident_revista=255&pident_usuario=0&ty=115&web=www.revespcardiol.org |
| PubMed reference number | 22464104v1 |
| Volume Number | 65 |
| Issue Number | 8 |
| Journal | Revista espanola de cardiologia |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Anticoagulants Anticoagulation Therapy Atrial Fibrillation Cardiac Death Cardiovascular Diseases Cerebrovascular accident Chromosome Deletion Confidence Intervals Diabetes Mellitus Ejection fraction (procedure) Heart Atrium Heart Diseases Heart Transplantation Hemorrhage Hospital admission Hospitalization Hypertensive disease Large Left ventricular ejection fraction Left-Sided Heart Failure Myocardial Ischemia Nasal sinus Pathological Dilatation Patients Propensity Score Registries Sinus - general anatomical term Tachycardia, Ventricular Thromboembolism Thrombosis Ventricular Dysfunction Ventricular Dysfunction, Left coronary revascularization width |
| Content Type | Text |
| Resource Type | Article |
