Thromboembolic risk in the patient with heart failure

被引：8

作者：

Klein L. ^{[1
]}

O'Connell J.B. ^{[1
]}

机构：

[1] Northwestern University Feinberg School of Medicine, Chicago, IL 60611

来源：

Current Treatment Options in Cardiovascular Medicine | 2007年 / 9卷 / 4期

关键词：

Warfarin; Clopidogrel; Enoxaparin; Heart Failure Patient; Venous Thromboembolism;

D O I：

10.1007/s11936-007-0026-1

中图分类号：

学科分类号：

摘要：

Although heart failure is a, procoagulant state, the incidence of arterial thromboembolism (peripheral arterial emboli and strokes) is relatively low in the outpatient setting and seems to be higher in those with concomitant atrial fibrillation or recent large anterior myocardial infarction, especially in the presence of a dyskinetic apex. Hospitalized heart failure patients, on the other hand, have an extremely high rate of deep venous thrombosis and pulmonary emboli. Outpatients with heart failure should receive anticoagulation only in the presence of atrial fibrillation or if they have experienced a prior embolic event. Patients with recent large anterior infarction or recent infarction with documented thrombus should be treated with anticoagulation for the initial 3 months after the infarct, whereas those with evidence of a mural thrombus should receive anticoagulation at least until the thrombus has resolved. Heart failure patients with ischemic cardiomyopathy should receive antiplatelet agents for the prevention of myocardial infarction, stroke, or death. Antiplatelet agents should not be prescribed for heart failure patients with nonischemic cardiomyopathy or without other evidence of atherosclerotic vascular disease. All hospitalized heart failure patients who are not taking oral anticoagulants should receive prophylaxis with low molecular weight heparins or factor Xa inhibitors. Copyright © 2007 by Current Medicine Group LLC.

引用

页码：310 / 317

页数：7

共 47 条

[1]

Jafri S.M., Ozawa T., Mammen E., Et al., Platelet function, thrombin and fibrinolytic activity in patients with heart failure, Eur Heart J, 14, pp. 205-212, (1993)

[2]

Yamamoto K., Ikeda U., Furuhashi K., Et al., The coagulation system is activated in idiopathic cardiomyopathy, J Am Coll Cardiol, 25, pp. 1634-1640, (1995)

[3]

Lip G.Y.H., Gibbs C.R., Does heart failure confer a hypercoagulable state?, J Am Coll Cardiol, 33, pp. 1424-1426, (1999)

[4]

Katz S.D., Hryniewicz K., Hriljac I., Et al., Vascular endothelial dysfunction and mortality risk in patients with chronic heart failure, Circulation, 111, pp. 310-314, (2005)

[5]

Belch J.J., Lowe G.D., Ward A.G., Et al., Prevention of deep vein thrombosis in medical patients by low-dose heparin, Scott Med J, 26, pp. 115-117, (1981)

[6]

Samama M.M., Cohen A.T., Darmon J.Y., Et al., A comparison of enoxaparin with placebo for the prevention of venous thromboembolism in acutely ill medical patients. Prophylaxis in Medical Patients with Enoxaparin Study Group, N Engl J Med, 341, pp. 793-800, (1999)

[7]

Alikhan R., Cohen A.T., Combe S., Et al., Risk factors for venous thromboembolism in hospitalized patients with acute medical illness. Analysis of the MEDENOX study, Arch Intern Med, 164, pp. 963-968, (2004)

[8]

Beemath A., Stein P.D., Skaf E., Et al., Risk of venous thromboembolism in patients hospitalized with heart failure, Am J Cardiol, 98, pp. 793-795, (2006)

[9]

Beemath A., Skaf E., Stein P.D., Pulmonary embolism as a cause of death in adults who died with heart failure, Am J Cardiol, 98, pp. 1073-1075, (2006)

[10]

Darze E.S., Latado A.L., Guimaraes A.G., Et al., Incidence and clinical predictors of pulmonary embolism in severe heart failure patients admitted to a coronary care unit, Chest, 128, pp. 2576-2580, (2005)

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