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Antithrombotic therapy in patients with heart failure

Wilson S Colucci, MD
Section Editor
Stephen S Gottlieb, MD
Deputy Editor
Susan B Yeon, MD, JD, FACC


Studies in patients with heart failure (HF), left ventricular systolic dysfunction, or both have noted high rates of thromboembolic events as compared to the general population. While more evidence is available on thromboembolic risk in patients with left ventricular systolic dysfunction (with or without HF), evidence suggests that HF with preserved ejection fraction is also be associated with excess thromboembolism and stroke risk. (See 'Epidemiology' below.)

Thrombus in the left heart chambers can lead to embolic stroke and other systemic embolic events, while pulmonary emboli and paradoxical emboli originate from either deep venous thrombus or thrombus in the right heart chambers. Low cardiac output, decreased physical activity, and peripheral edema all predispose to venous thrombi.

This topic will discuss the risk of thromboembolism and indications for anticoagulation in patients with HF.

Antithrombotic therapy in clinical settings that may be associated with HF is discussed separately:

(See "Atrial fibrillation: Anticoagulant therapy to prevent embolization".)

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Literature review current through: Nov 2017. | This topic last updated: Oct 12, 2016.
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