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European Journal of Heart Failure 2000 2(4):355-363; doi:10.1016/S1388-9842(00)00126-4
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© 2000 European Society of Cardiology

Thromboembolism in heart failure: who should be treated?

Frank Diet* and Erland Erdmann

Klinik III für Innere Medizin, Universität zu Köln Joseph-Stelzmann-Str. 9, 50924 Köln, Germany

* Corresponding author. Tel.: +49-221-478 6205; fax: +49-221-478 6490. E-mail address: f.diet{at}uni-koeln.de (F. Diet).


  Abstract

The risk of thromboembolic complications in patients with heart failure and/or chronic left-ventricular systolic dysfunction is increased. Nevertheless, anticoagulant therapy in these patients is still a subject of debate. Atrial fibrillation is the only prospectively evaluated, proven thromboembolic risk factor and patients with atrial fibrillation benefit from long term anticoagulant therapy. The significance of other proposed thromboembolic risk factors in heart failure and/or chronic left-ventricular dysfunction such as gender, cause of myocardial disease, severity of heart failure, left-ventricular ejection fraction, left-ventricular thrombus, left ventricular aneurysm and history of previous thromboembolic event is less clear. This article summarizes key studies, assesses the incidence of thromboembolism, evaluates risk factors and proposes guidelines for anticoagulation of patients with heart failure and/or left ventricular systolic dysfunction.

Key Words: Thromboembolism • Anticoagulant • Atrial fibrillation

Received January 25, 2000; Accepted September 12, 2000


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