Heart failure: arterial thromboembolic events are uncommon

Clinical bottom line (level 2a)

  1. Roughly 2% of patients with chronic heart failure have arterial thromboembolic events per year.
Baker and Wright: Journal of the American Medical Association 1994; 272 (20): 1614-1618
Expires October 2003

The study

Systematic review of all of
  • Patients: with chronic heart failure due to left ventricular dysfunction
  • Intervention: not receiving anticoagulant therapy
  • Outcome: arterial thromboembolism


    • Articles found in English using Medline, 1966 to 1993 (search terms: anticoagulation, cerebrovascular disorders, stroke and thromboembolism, and heart failure, congestive; congestive heart failure; heart failure; cardiac failure; dilated cardiomyopathy ) and searching references from review articles and textbooks

    Selection criteria: see above
    Appraisal criteria: not detailed
    Articles excluded if:
    • heart failure due to valvular heart disease, Chagas' disease, or myocardial infarction


    11 studies found

    The evidence

    • Incidence of arterial thromboembolism: 0.9% to 5.5% per year
    • The largest studies reported rates of 2.0 to 2.4% per year

    Comments

    1. No randomised controlled trials were found.
    2. No adjustment for confounding factors like hypertension or atrial fibrillation were made.

    Citation

    1. Baker DW, and Wright RF: management of heart failure IV anticoagulation for patients with heart failure due to left ventricular systolic dysfunction. Journal of the American Medical Association 1994; 272 (20): 1614-1618
    Contributor: Chris Ball and Clare Wotton, October 1999
    Reviewer:

    Clinical Question.
    Patient heart failure
    Intervention or Exposure no anticoagulation, prevalence
    Outcome arterial thromboembolic events