Anticoagulation in Patients with Dilated Cardiomyopathy, Low Ejection Fraction, and Sinus Rhythm: Back to the Drawing Board
Summary Heart failure patients present an important thrombo‐embolic risk, including symptomatic or silent peripheral arterial embolism, pulmonary embolism, and stroke. Patients in sinus rhythm who have concomitant depressed (
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| Veröffentlicht in: | Cardiovascular therapeutics 2013-10, Vol.31 (5), p.298-302 |
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| container_title | Cardiovascular therapeutics |
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| creator | Mischie, Alexandru Nicolae Chioncel, Valentin Droc, Ionel Sinescu, Crina |
| description | Summary
Heart failure patients present an important thrombo‐embolic risk, including symptomatic or silent peripheral arterial embolism, pulmonary embolism, and stroke. Patients in sinus rhythm who have concomitant depressed ( |
| doi_str_mv | 10.1111/1755-5922.12019 |
| format | Article |
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Heart failure patients present an important thrombo‐embolic risk, including symptomatic or silent peripheral arterial embolism, pulmonary embolism, and stroke. Patients in sinus rhythm who have concomitant depressed (<35%) left ventricular ejection fraction have a 4% rate of embolic events. Several prospective randomized trials of anticoagulation in this group of patients were either underpowered or had a short period of follow‐up. Even though in two studies warfarin had a slight advantage over aspirin (in the WATCH and WARCEF trials), it was at the cost of an increased risk in major hemorrhage. To decrease bleeding rates and to improve anticoagulant effect, new treatment strategies have to be tested. Novel anticoagulants (dabigatran, rivaroxaban, and apixaban) seem to be a promising alternative.</description><identifier>ISSN: 1755-5914</identifier><identifier>EISSN: 1755-5922</identifier><identifier>DOI: 10.1111/1755-5922.12019</identifier><identifier>PMID: 23279759</identifier><language>eng</language><publisher>Oxford: Blackwell</publisher><subject>Anticoagulants ; Anticoagulants - adverse effects ; Apixaban ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiomyopathy, Dilated - complications ; Cardiomyopathy, Dilated - drug therapy ; Cardiomyopathy, Dilated - physiopathology ; Cardiovascular system ; Clinical Trials as Topic ; Dabigatran ; Dilated cardiomyopathy ; Drug therapy ; Embolisms ; Fractions ; Heart ; Heart failure ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Heart Rate ; Humans ; Low ejection fraction <35 ; Medical sciences ; Myocarditis. Cardiomyopathies ; Pharmacology. Drug treatments ; Rivaroxaban ; Sinus rhythm ; Stroke - epidemiology ; Stroke Volume</subject><ispartof>Cardiovascular therapeutics, 2013-10, Vol.31 (5), p.298-302</ispartof><rights>2012 John Wiley & Sons Ltd</rights><rights>2014 INIST-CNRS</rights><rights>2012 John Wiley & Sons Ltd.</rights><rights>Copyright © 2013 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4019-65e86928f2007b85b5f00fc3e1ff98a8bf666ad45883f7df7a14267002eb4ded3</citedby><cites>FETCH-LOGICAL-c4019-65e86928f2007b85b5f00fc3e1ff98a8bf666ad45883f7df7a14267002eb4ded3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1755-5922.12019$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1755-5922.12019$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1433,11562,27924,27925,46052,46409,46476,46833</link.rule.ids><linktorsrc>$$Uhttps://onlinelibrary.wiley.com/doi/abs/10.1111%2F1755-5922.12019$$EView_record_in_Wiley-Blackwell$$FView_record_in_$$GWiley-Blackwell</linktorsrc><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27738946$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23279759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mischie, Alexandru Nicolae</creatorcontrib><creatorcontrib>Chioncel, Valentin</creatorcontrib><creatorcontrib>Droc, Ionel</creatorcontrib><creatorcontrib>Sinescu, Crina</creatorcontrib><title>Anticoagulation in Patients with Dilated Cardiomyopathy, Low Ejection Fraction, and Sinus Rhythm: Back to the Drawing Board</title><title>Cardiovascular therapeutics</title><addtitle>Cardiovasc Ther</addtitle><description>Summary
Heart failure patients present an important thrombo‐embolic risk, including symptomatic or silent peripheral arterial embolism, pulmonary embolism, and stroke. Patients in sinus rhythm who have concomitant depressed (<35%) left ventricular ejection fraction have a 4% rate of embolic events. Several prospective randomized trials of anticoagulation in this group of patients were either underpowered or had a short period of follow‐up. Even though in two studies warfarin had a slight advantage over aspirin (in the WATCH and WARCEF trials), it was at the cost of an increased risk in major hemorrhage. To decrease bleeding rates and to improve anticoagulant effect, new treatment strategies have to be tested. Novel anticoagulants (dabigatran, rivaroxaban, and apixaban) seem to be a promising alternative.</description><subject>Anticoagulants</subject><subject>Anticoagulants - adverse effects</subject><subject>Apixaban</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiomyopathy, Dilated - complications</subject><subject>Cardiomyopathy, Dilated - drug therapy</subject><subject>Cardiomyopathy, Dilated - physiopathology</subject><subject>Cardiovascular system</subject><subject>Clinical Trials as Topic</subject><subject>Dabigatran</subject><subject>Dilated cardiomyopathy</subject><subject>Drug therapy</subject><subject>Embolisms</subject><subject>Fractions</subject><subject>Heart</subject><subject>Heart failure</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Low ejection fraction <35</subject><subject>Medical sciences</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Pharmacology. Drug treatments</subject><subject>Rivaroxaban</subject><subject>Sinus rhythm</subject><subject>Stroke - epidemiology</subject><subject>Stroke Volume</subject><issn>1755-5914</issn><issn>1755-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1vFCEYxonR2Fo9ezMkxsRDtwVm-Jje2t1WTTbRVD1PGAY6rDOwApPNpP982Q_XxItceAK_93lfeAB4i9EFzusSc0pntCLkAhOEq2fg9Hjy_KhxeQJexbhCiKGK4ZfghBSEV5xWp-Dx2iWrvHwYe5msd9A6-C0r7VKEG5s6uLD5RrdwLkNr_TD5tUzddA6XfgNvV1rtqu6C3IlzKF0Lv1s3RnjfTakbruCNVL9g8jB1Gi6C3Fj3AG98dnsNXhjZR_3msJ-Bn3e3P-afZ8uvn77Mr5czVeY3zRjVglVEGIIQbwRtqEHIqEJjYyohRWMYY7ItqRCF4a3hEpeEcYSIbspWt8UZ-Lj3XQf_e9Qx1YONSve9dNqPscZlQRimGImMvv8HXfkxuDzdlsJUEMqKTF3uKRV8jEGbeh3sIMNUY1Rvc6m3P19vU6h3ueSKdwffsRl0e-T_BJGBDwdARiV7E6RTNv7lOC9EVbLM0T23sb2e_te3ni_u9wM8AQZRo28</recordid><startdate>201310</startdate><enddate>201310</enddate><creator>Mischie, Alexandru Nicolae</creator><creator>Chioncel, Valentin</creator><creator>Droc, Ionel</creator><creator>Sinescu, Crina</creator><general>Blackwell</general><general>Hindawi Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201310</creationdate><title>Anticoagulation in Patients with Dilated Cardiomyopathy, Low Ejection Fraction, and Sinus Rhythm: Back to the Drawing Board</title><author>Mischie, Alexandru Nicolae ; Chioncel, Valentin ; Droc, Ionel ; Sinescu, Crina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4019-65e86928f2007b85b5f00fc3e1ff98a8bf666ad45883f7df7a14267002eb4ded3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Anticoagulants</topic><topic>Anticoagulants - adverse effects</topic><topic>Apixaban</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiomyopathy, Dilated - complications</topic><topic>Cardiomyopathy, Dilated - drug therapy</topic><topic>Cardiomyopathy, Dilated - physiopathology</topic><topic>Cardiovascular system</topic><topic>Clinical Trials as Topic</topic><topic>Dabigatran</topic><topic>Dilated cardiomyopathy</topic><topic>Drug therapy</topic><topic>Embolisms</topic><topic>Fractions</topic><topic>Heart</topic><topic>Heart failure</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Low ejection fraction <35</topic><topic>Medical sciences</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Pharmacology. Drug treatments</topic><topic>Rivaroxaban</topic><topic>Sinus rhythm</topic><topic>Stroke - epidemiology</topic><topic>Stroke Volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mischie, Alexandru Nicolae</creatorcontrib><creatorcontrib>Chioncel, Valentin</creatorcontrib><creatorcontrib>Droc, Ionel</creatorcontrib><creatorcontrib>Sinescu, Crina</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Cardiovascular therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Mischie, Alexandru Nicolae</au><au>Chioncel, Valentin</au><au>Droc, Ionel</au><au>Sinescu, Crina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anticoagulation in Patients with Dilated Cardiomyopathy, Low Ejection Fraction, and Sinus Rhythm: Back to the Drawing Board</atitle><jtitle>Cardiovascular therapeutics</jtitle><addtitle>Cardiovasc Ther</addtitle><date>2013-10</date><risdate>2013</risdate><volume>31</volume><issue>5</issue><spage>298</spage><epage>302</epage><pages>298-302</pages><issn>1755-5914</issn><eissn>1755-5922</eissn><abstract>Summary
Heart failure patients present an important thrombo‐embolic risk, including symptomatic or silent peripheral arterial embolism, pulmonary embolism, and stroke. Patients in sinus rhythm who have concomitant depressed (<35%) left ventricular ejection fraction have a 4% rate of embolic events. Several prospective randomized trials of anticoagulation in this group of patients were either underpowered or had a short period of follow‐up. Even though in two studies warfarin had a slight advantage over aspirin (in the WATCH and WARCEF trials), it was at the cost of an increased risk in major hemorrhage. To decrease bleeding rates and to improve anticoagulant effect, new treatment strategies have to be tested. Novel anticoagulants (dabigatran, rivaroxaban, and apixaban) seem to be a promising alternative.</abstract><cop>Oxford</cop><pub>Blackwell</pub><pmid>23279759</pmid><doi>10.1111/1755-5922.12019</doi><tpages>5</tpages></addata></record> |
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| subjects | Anticoagulants Anticoagulants - adverse effects Apixaban Biological and medical sciences Cardiology. Vascular system Cardiomyopathy, Dilated - complications Cardiomyopathy, Dilated - drug therapy Cardiomyopathy, Dilated - physiopathology Cardiovascular system Clinical Trials as Topic Dabigatran Dilated cardiomyopathy Drug therapy Embolisms Fractions Heart Heart failure Heart failure, cardiogenic pulmonary edema, cardiac enlargement Heart Rate Humans Low ejection fraction <35 Medical sciences Myocarditis. Cardiomyopathies Pharmacology. Drug treatments Rivaroxaban Sinus rhythm Stroke - epidemiology Stroke Volume |
| title | Anticoagulation in Patients with Dilated Cardiomyopathy, Low Ejection Fraction, and Sinus Rhythm: Back to the Drawing Board |
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