Congestive heart failure and thromboembolism
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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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. Treatment with amiodarone or implantable cardiac defibrillator device is associated with a lower rate of thromboembolism. Hypertension and a lower left ventricular ejection fraction were independently associated with higher rates of thromboembolism.
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)