Efficacy of antithrombotic therapy in chronic heart failure: the HELAS study.

Abstract:

BACKGROUND:It is not clear if long-term antithrombotic treatment has a beneficial effect on the incidence of thromboembolism in chronic heart failure (CHF). The HELAS study (Heart failure Long-term Antithrombotic Study) is a multicentre, randomised, double-blind, placebo-controlled trial to evaluate antithrombotic treatment in patients with CHF. METHODS:197HF patients (EF <35%) were enrolled. Patients with Ischaemic Heart Disease were randomised to receive either aspirin 325mg or warfarin. Patients with Dilated Cardiomyopathy (DCM) were randomised to receive either warfarin or placebo. RESULTS:Analysis of the data from 312 patient years showed an incidence of 2.2 embolic events per 100 patient years, with no significant difference between groups. The incidence of myocardial infarction, hospitalisation, exacerbation of heart failure, death and haemorrhage were not different between the groups. No peripheral or pulmonary emboli were reported. Echocardiographic follow-up for 2years showed an overall increase in left ventricular ejection fraction from 28.2+/-6 to 30.3+/-7 p<0.05, which was most obvious in patients with DCM taking warfarin (EF 26.8+/-5.3 at baseline, 30.7+/-10 at 2 years, p<0.05). CONCLUSIONS:(1) Overall embolic events are rare in heart failure regardless of treatment. (2) Treatment does not seem to affect outcome.

journal_name

Eur J Heart Fail

authors

Cokkinos DV,Haralabopoulos GC,Kostis JB,Toutouzas PK,HELAS investigators.

doi

10.1016/j.ejheart.2006.02.012

subject

Has Abstract

pub_date

2006-06-01 00:00:00

pages

428-32

issue

4

eissn

1388-9842

issn

1879-0844

pii

S1388-9842(06)00064-X

journal_volume

8

pub_type

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