Oral anticoagulation therapy in heart failure patients in sinus rhythm: a systematic review and meta-analysis.
Oral anticoagulation therapy in heart failure patients in sinus rhythm: a systematic review and meta-analysis.
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DOI：
10.1371/journal.pone.0052952
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Leosco D
中科院分区：
文献类型：
--
作者：
Rengo G;Pagano G;Squizzato A;Moja L;Femminella GD;de Lucia C;Komici K;Parisi V;Savarese G;Ferrara N;Perrone-Filardi P;Leosco D
Heart failure (HF) patients show high morbidity and mortality rate with increased risk of malignant arrhythmia and thromboembolism. Anticoagulation reduces embolic event and death rates in HF patients with atrial fibrillation, but if antithrombotic therapy is beneficial in patients with HF in sinus rhythm is still debated. We conducted a systematic review of prospective, randomized controlled trials (RCTs) to assess the efficacy and safety of oral anticoagulant therapies (OATs) compared to antiplatelet treatment in HF patients in sinus rhythm. MEDLINE, Web of Science, CENTRAL and Scopus databases were searched up to May 2012. Four RCTs were identified and a total of 3663 patients were included in the meta-analysis. Patients with both ischemic and non-ischemic HF were included. There was no significant difference in mortality (odds ratio (OR) 1.01, 95% confidence interval (CI) 0.86 to 1.19) between OATs group and antiplatelet drug group. OATs have reduced ischemic stroke risk (OR 0.49, 95% CI 0.32 to 0.74), but have increased major bleeding risk (OR 2.01, 95% CI 1.40 to 2.88) compared to antiplatelet treatment. In HF patients in sinus rhythm OATs do not show a better risk-benefit profile compared to antiplatelet treatment in cardioembolism prevention. Warfarin and aspirin seem to be similar in reducing mortality. Warfarin reduces the incidence of ischemic stroke, but increases major bleedings. Thus, it is possible to speculate that aspirin prescription be indicated in patients with high risk of bleeding, whereas warfarin could be preferred in patients with high thromboembolic risk.
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影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
39.2
作者：
Gottdiener, JS;McClelland, RL;Manolio, TA
通讯作者：
Manolio, TA
影响因子：
4.8
作者：
Cleland, JGF;Findlay, I;Poole-Wilson, PA
通讯作者：
Poole-Wilson, PA
影响因子：
18.2
作者：
Cokkinos, DV;Haralabopoulos, GC;Toutouzas, PK
通讯作者：
Toutouzas, PK
DOI：
10.1056/nejmoa1202299
发表时间：
2012-05-17
期刊：
The New England journal of medicine
影响因子：
--
作者：
Homma S;Thompson JL;Pullicino PM;Levin B;Freudenberger RS;Teerlink JR;Ammon SE;Graham S;Sacco RL;Mann DL;Mohr JP;Massie BM;Labovitz AJ;Anker SD;Lok DJ;Ponikowski P;Estol CJ;Lip GY;Di Tullio MR;Sanford AR;Mejia V;Gabriel AP;del Valle ML;Buchsbaum R;WARCEF Investigators
通讯作者：
WARCEF Investigators