Role of antithrombotic agents in heart failure

Cleland, J. G.F. , Mumtaz, S. and Cecchini, L. (2012) Role of antithrombotic agents in heart failure. Current Cardiology Reports, 14(3), pp. 314-325. (doi: 10.1007/s11886-012-0266-x) (PMID:22467260)

Abstract

Despite a vast body of research on antithrombotic therapy for patients with cardiac disease, there are few clinical settings where robust evidence of their benefit exists. Patients with heart failure often have vascular disease and atrial fibrillation contributing to their poor prognosis. For patients with heart failure and atrial fibrillation, anticoagulants are appropriate. For patients with heart failure in sinus rhythm, the weight of evidence suggests that doctors should generally avoid using any antithrombotic agent even if the patient has coronary artery disease. If there is a compulsion to treat, then there is less evidence of harm with clopidogrel or warfarin than with aspirin, although most receive aspirin. More research is required for this “evidence-light” problem. For those with the opportunity, engaging with a randomized trial is clinically and scientifically appropriate. The dilemma for such studies is the comparator. Should it be against or in addition to “standard of care” or both?

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cleland, Professor John
• Authors: Cleland, J. G.F., Mumtaz, S., and Cecchini, L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Current Cardiology Reports
• ISSN: 1523-3782
• ISSN (Online): 1534-3170
• Published Online: 31 March 2012