Ciddi sol ventrikül disfonksiyonlu hastalarda Warfarin risk faktörü

6. Yıllık Heart Failure Society of America (HFSA) toplantısında sunulan bir posterde Warfarin alan sol ventrikül disfonksiyonlu ciddi kalp yetmezlikli olgularda tromboembolik komplikasyonların arttığı gösterildi.
HFSA: Warfarin an Independent Risk Factor for Adverse Events in Class II and Class IV Heart Failure Patients
BOCA RATON, FL -- September 27, 2002 -- Patients on warfarin appear to have a significantly higher incidence of embolic events than heart failure patients not treated with warfarin.

Researchers from St. Vincent"s Medical Center in Bridgeport, Connecticut, United States, led by Dr. Kathleen Harper, presented their findings at a poster session here September 24th at the 6th Annual Scientific Meeting of the Heart Failure Society of America (HFSA).

In this retrospective study of 93 heart failure patients with severe left ventricular dysfunction, mean ejection fraction (EF) 21 percent, patients were categorized into two groups -- those taking warfarin and those not on warfarin. Researchers reviewed patients" incidence of arterial or venous thromboembolic events over a three-year period. They recorded significant events such as transient ischemic attacks (TIA), cerebrovascular accident (CVA), pulmonary embolus and deep-vein thrombosis (DVT).

Of the 93 patients in the study, 46 of them (with a mean EF of 21 percent) were on warfarin and 47 patients (with a mean EF of 20 percent) were not on warfarin. Twelve of the 46 warfarin patients (26 percent) experienced embolic events and 75 percent had atrial fibrillation. In comparison, only two out of 47, or four percent, of non-warfarin patients sustained embolic events. None of them had atrial fibrillation.

"Differences in outcome may reflect variable bioavailability of warfarin in a challenging patient population where transient hepatic congestion and hypercoaguability maintain a fine balance," the researchers concluded. "The onset of atrial fibrillation provides compelling evidence for the use of warfarin."

However, they caution that further study is needed in the non-atrial fibrillation cardiomyopathy population before recommendations can be made.

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