Efficacy of antithrombotic therapy in chronic heart failure: The HELAS study
Efficacy of antithrombotic therapy in chronic heart failure: The HELAS study
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DOI：
10.1016/j.ejheart.2006.02.012
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发表时间：
2006-06-01
影响因子：
18.2
通讯作者：
Toutouzas, PK
中科院分区：
文献类型：
--
作者：
Cokkinos, DV;Haralabopoulos, GC;Toutouzas, PK
背景资料：目前尚不清楚长期抗血栓治疗是否对慢性心力衰竭（CHF）患者血栓栓塞的发生率有有益影响。HELAS研究（Heart failure Long-term Antithrombotic Study）是一项多中心、随机、双盲、安慰剂对照试验，旨在评价CHF患者的抗血栓治疗。缺血性心脏病患者随机接受阿司匹林325 mg或华法林治疗。扩张型心肌病（DCM）患者随机接受华法林或安慰剂。结果：从312患者年的数据分析显示，栓塞事件的发生率为2.2每100患者年，组间无显着差异。两组间心肌梗死、住院、心力衰竭加重、死亡和出血的发生率无差异。未报告外周或肺栓塞。超声心动图随访2年显示左心室射血分数总体上从28.2 +/-6增加到30.3 +/-7 p < 0.05，在服用华法林的DCM患者中最明显（基线时EF 26.8 ± 5.3，2年时30.7 ± 10，p < 0.05）。结论：（1）无论治疗如何，心力衰竭患者的总体栓塞事件都是罕见的。(2)治疗似乎不影响结果。(c)2006年欧洲心脏病学会。Elsevier B. V.出版，保留所有权利。
Background: It is not clear if long-term antithrombotic treatment has a beneficial effect on the incidence of thromboembolism in chronic heart failure (CHF). The HELAS study (Heart failure Long-term Antithrombotic Study) is a multicentre, randomised, double-blind, placebo-controlled trial to evaluate antithrombotic treatment in patients with CHF.Methods: 197HF patients (EF < 35%) were enrolled. Patients with Ischaemic Heart Disease were randomised to receive either aspirin 325mg or warfarin. Patients with Dilated Cardiomyopathy (DCM) were randomised to receive either warfarin or placebo.Results: Analysis of the data from 312 patient years showed an incidence of 2.2 embolic events per 100 patient years, with no significant difference between groups. The incidence of myocardial infarction, hospitalisation, exacerbation of heart failure, death and haemorrhage were not different between the groups. No peripheral or pulmonary emboli were reported. Echocardiographic follow-up for 2 years showed an overall increase in left ventricular ejection fraction from 28.2 +/- 6 to 30.3 +/- 7 p < 0.05, which was most obvious in patients with DCM taking warfarin (EF 26.8 +/- 5.3 at baseline, 30.7 +/- 10 at 2 years, p < 0.05).Conclusions: (1) Overall embolic events are rare in heart failure regardless of treatment. (2) Treatment does not seem to affect outcome. (c) 2006 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.