Congestive heart failure and thrombosis: Difference between revisions
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===Supportive Trial Data=== | ===Supportive Trial Data=== | ||
The Warfarin and Antiplatelet Therapy in Chronic Heart Failure ('''WATCH'''<ref name="pmid15101020">{{cite journal| author=Massie BM, Krol WF, Ammon SE, Armstrong PW, Cleland JG, Collins JF et al.| title=The Warfarin and Antiplatelet Therapy in Heart Failure trial (WATCH): rationale, design, and baseline patient characteristics. | journal=J Card Fail | year= 2004 | volume= 10 | issue= 2 | pages= 101-12 | pmid=15101020 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15101020 }} </ref>) trial was the first modern RCT to study [[warfarin]] in patients with heart failure. The trial showed a reduction of nonfatal [[stroke]] events with warfarin over [[aspirin]] or [[clopidogrel]]. | *The Warfarin and Antiplatelet Therapy in Chronic Heart Failure ('''WATCH'''<ref name="pmid15101020">{{cite journal| author=Massie BM, Krol WF, Ammon SE, Armstrong PW, Cleland JG, Collins JF et al.| title=The Warfarin and Antiplatelet Therapy in Heart Failure trial (WATCH): rationale, design, and baseline patient characteristics. | journal=J Card Fail | year= 2004 | volume= 10 | issue= 2 | pages= 101-12 | pmid=15101020 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15101020 }} </ref>) trial was the first modern RCT to study [[warfarin]] in patients with heart failure. The trial showed a reduction of nonfatal [[stroke]] events with warfarin over [[aspirin]] or [[clopidogrel]]. | ||
* In the ARixtra for ThromboEMbolISm prevention in a medical indications study ('''ARTEMIS'''<ref name="pmid16439370">{{cite journal| author=Cohen AT, Davidson BL, Gallus AS, Lassen MR, Prins MH, Tomkowski W et al.| title=Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial. | journal=BMJ | year= 2006 | volume= 332 | issue= 7537 | pages= 325-9 | pmid=16439370 | doi=10.1136/bmj.38733.466748.7C | pmc=PMC1363908 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16439370 }} </ref>) trial in acutely ill medical patients, [[fondaparinux]] significantly reduced the risk of total [[venous thromboembolism]], without increasing bleeding risk compared with placebo. | |||
==See also== | ==See also== | ||
Revision as of 00:57, 3 October 2011
Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]
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Thrombosis Microchapters |
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Site of Thrombosis |
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Differentiating Thrombosis from other Diseases |
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Diagnosis |
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Treatment |
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Congestive heart failure and thrombosis On the Web |
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to Hospitals Treating Congestive heart failure and thrombosis |
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Risk calculators and risk factors for Congestive heart failure and thrombosis |
Overview
Heart failure is one of the most important public health problems, afflicting an approximate half million patients in United States, with more than 400,000 new cases each year, and many more worldwide[1]. CHF results when heart is not able to meet the demands of circulation causing insufficient blood flow. These patients are at higher risk of arterial and venous thrombosis.
Historical Perspective
Throughout history many renowned researchers and health care professionals have contributed to the understanding, definition, and recognition of thrombosis in Heart Failure patients.[2] [3] [4]
| Year | Event |
| 1950s | Prognosis appeared better in Anticouagulated patient. |
| 1960s - 1970s | Retrospective analysis and Autopsy findings showed thromboembolism as an etiology. |
| 1980s - 1990s | Better understanding of hypercoaugubilty in Heart failure patients. |
| 2000- | Role of Aspirin in heart failure patients is studied. |
Pathophysiology
Stagnation of blood flow, disorder in vascular wall, and blood coagulation system are known factors that participate in the thrombosis formation.
Treatment
Rationale for Antithrombotic therapy in Heart failure
- Prevention of Stroke[5],
- Prevention of Systemic or Pulmonary embolism,
- Prevention of coronary thrombosis,
- Retarding progression of Heart failure.
- Increase survival.
Supportive Trial Data
- The Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH[6]) trial was the first modern RCT to study warfarin in patients with heart failure. The trial showed a reduction of nonfatal stroke events with warfarin over aspirin or clopidogrel.
- In the ARixtra for ThromboEMbolISm prevention in a medical indications study (ARTEMIS[7]) trial in acutely ill medical patients, fondaparinux significantly reduced the risk of total venous thromboembolism, without increasing bleeding risk compared with placebo.
See also
References
- ↑ Massie BM, Shah NB (1997). "Evolving trends in the epidemiologic factors of heart failure: rationale for preventive strategies and comprehensive disease management". Am Heart J. 133 (6): 703–12. PMID 9200399.
- ↑ WISHART JH, CHAPMAN CB (1948). "Dicumarol therapy in congestive heart failure". N Engl J Med. 239 (19): 701–4. doi:10.1056/NEJM194811042391902. PMID 18892580.
- ↑ HARVEY WP, FINCH CA (1950). "Dicumarol prophylaxis of thromboembolic disease in congestive heart failure". N Engl J Med. 242 (6): 208–11. doi:10.1056/NEJM195002092420603. PMID 15403339.
- ↑ GRIFFITH GC, STRAGNELL R, LEVINSON DC, MOORE FJ, WARE AG (1952). "A study of the beneficial effects of anticoagulant therapy in congestive heart failure". Ann Intern Med. 37 (5): 867–87. PMID 12986600.
- ↑ Kannel WB, Wolf PA, Verter J (1983). "Manifestations of coronary disease predisposing to stroke. The Framingham study". JAMA. 250 (21): 2942–6. PMID 6227757.
- ↑ Massie BM, Krol WF, Ammon SE, Armstrong PW, Cleland JG, Collins JF; et al. (2004). "The Warfarin and Antiplatelet Therapy in Heart Failure trial (WATCH): rationale, design, and baseline patient characteristics". J Card Fail. 10 (2): 101–12. PMID 15101020.
- ↑ Cohen AT, Davidson BL, Gallus AS, Lassen MR, Prins MH, Tomkowski W; et al. (2006). "Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial". BMJ. 332 (7537): 325–9. doi:10.1136/bmj.38733.466748.7C. PMC 1363908. PMID 16439370.