Congestive heart failure and thromboembolism: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
Patients with [[congestive heart failure]] are at an increase risk of thromboembolic events. These events include [[stroke]], [[transient ischemic attack]], [[deep vein thrombosis]] and [[pulmonary embolism]]. The risk of thromboembolism in the absence of [[atrial fibrillation]] or [[atrial flutter]] is about 1% per year. [[Hypertension]] and a lower [[left ventricular ejection fraction]] | Patients with [[congestive heart failure]] are at an increase risk of thromboembolic events. These events include [[stroke]], [[transient ischemic attack]], [[deep vein thrombosis]] and [[pulmonary embolism]]. The risk of thromboembolism in the absence of [[atrial fibrillation]] or [[atrial flutter]] is about 1% per year<ref name="pmid17485579">{{cite journal |author=Freudenberger RS, Hellkamp AS, Halperin JL, Poole J, Anderson J, Johnson G, Mark DB, Lee KL, Bardy GH |title=Risk of thromboembolism in heart failure: an analysis from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) |journal=[[Circulation]] |volume=115 |issue=20 |pages=2637–41 |year=2007 |month=May |pmid=17485579 |doi=10.1161/CIRCULATIONAHA.106.661397 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=17485579 |issn= |accessdate=2011-04-26}}</ref>. [[Hypertension]] and a lower [[left ventricular ejection fraction]] have been independently associated with higher rates of thromboembolism<ref name="pmid17485579">{{cite journal |author=Freudenberger RS, Hellkamp AS, Halperin JL, Poole J, Anderson J, Johnson G, Mark DB, Lee KL, Bardy GH |title=Risk of thromboembolism in heart failure: an analysis from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) |journal=[[Circulation]] |volume=115 |issue=20 |pages=2637–41 |year=2007 |month=May |pmid=17485579 |doi=10.1161/CIRCULATIONAHA.106.661397 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=17485579 |issn= |accessdate=2011-04-26}}</ref>. It has been hypothesized that a lower ejection fraction may predispose patients to mural thrombosis and thereby increase the risk of thromboembolism<ref name="pmid17485579">{{cite journal |author=Freudenberger RS, Hellkamp AS, Halperin JL, Poole J, Anderson J, Johnson G, Mark DB, Lee KL, Bardy GH |title=Risk of thromboembolism in heart failure: an analysis from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) |journal=[[Circulation]] |volume=115 |issue=20 |pages=2637–41 |year=2007 |month=May |pmid=17485579 |doi=10.1161/CIRCULATIONAHA.106.661397 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=17485579 |issn= |accessdate=2011-04-26}}</ref>. | ||
The incidence of thromboembolism in other trials has been reported as follows: | The incidence of thromboembolism in other trials has been reported as follows: | ||
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==Treatment and Prevention== | ==Treatment and Prevention== | ||
Treatment with [[amiodarone]] or [[implantable cardiac defibrillator]] device is associated with a lower rate of thromboembolism. It has been postulated that these drugs and devices reduce the frequency of atrial fibrillation and atrial flutter and thereby reduce the risk of embolization. | Treatment with [[amiodarone]] or [[implantable cardiac defibrillator]] device is associated with a lower rate of thromboembolism<ref name="pmid17485579">{{cite journal |author=Freudenberger RS, Hellkamp AS, Halperin JL, Poole J, Anderson J, Johnson G, Mark DB, Lee KL, Bardy GH |title=Risk of thromboembolism in heart failure: an analysis from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) |journal=[[Circulation]] |volume=115 |issue=20 |pages=2637–41 |year=2007 |month=May |pmid=17485579 |doi=10.1161/CIRCULATIONAHA.106.661397 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=17485579 |issn= |accessdate=2011-04-26}}</ref>. It has been postulated that these drugs and devices reduce the frequency of [[atrial fibrillation]] and [[atrial flutter]] and thereby reduce the risk of [[embolization]]. | ||
==References== | ==References== | ||
Revision as of 21:54, 26 April 2011
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Epidemiology and Demographics
Patients with congestive heart failure are at an increase risk of thromboembolic events. These events include stroke, transient ischemic attack, deep vein thrombosis and pulmonary embolism. The risk of thromboembolism in the absence of atrial fibrillation or atrial flutter is about 1% per year[1]. Hypertension and a lower left ventricular ejection fraction have been independently associated with higher rates of thromboembolism[1]. It has been hypothesized that a lower ejection fraction may predispose patients to mural thrombosis and thereby increase the risk of thromboembolism[1].
The incidence of thromboembolism in other trials has been reported as follows:
- Vasodilator Heart Failure Trial (V-HeFT) I 2.7% per year
- V-HeFT II 2.1% per year
Outside of clinical trials, and in populations in whom atrial fibrillation is present, the risk is even higher (4.1% per year in the Framingham Heart Study)
Treatment and Prevention
Treatment with amiodarone or implantable cardiac defibrillator device is associated with a lower rate of thromboembolism[1]. It has been postulated that these drugs and devices reduce the frequency of atrial fibrillation and atrial flutter and thereby reduce the risk of embolization.
References
- ↑ 1.0 1.1 1.2 1.3 Freudenberger RS, Hellkamp AS, Halperin JL, Poole J, Anderson J, Johnson G, Mark DB, Lee KL, Bardy GH (2007). "Risk of thromboembolism in heart failure: an analysis from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT)". Circulation. 115 (20): 2637–41. doi:10.1161/CIRCULATIONAHA.106.661397. PMID 17485579. Retrieved 2011-04-26. Unknown parameter
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