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Titolo:
SYSTEMIC THROMBOEMBOLISM IN CHRONIC HEART-FAILURE - A PROSPECTIVE-STUDY IN 406 PATIENTS
Autore:
CIOFFI G; POZZOLI M; FORNI G; FRANCHINI M; OPASICH C; COBELLI F; TAVAZZI L;
Indirizzi:
MONTESCANO MED CTR,DEPT CARDIOL,SALVATORE MAUGERI FDN,INST CARE & RESI-27047 MONTESCANO PAVIA ITALY
Titolo Testata:
European heart journal
fascicolo: 9, volume: 17, anno: 1996,
pagine: 1381 - 1389
SICI:
0195-668X(1996)17:9<1381:STICH->2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR THROMBUS; TWO-DIMENSIONAL ECHOCARDIOGRAPHY; IDIOPATHIC DILATED CARDIOMYOPATHY; ANTICOAGULANT-THERAPY; MYOCARDIAL-INFARCTION; ATRIAL-FIBRILLATION; MITRAL REGURGITATION; FOLLOW-UP; RISK; FREQUENCY;
Keywords:
SYSTEMIC THROMBOEMBOLISM; HEART FAILURE; ECHOCARDIOGRAPHY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
34
Recensione:
Indirizzi per estratti:
Citazione:
G. Cioffi et al., "SYSTEMIC THROMBOEMBOLISM IN CHRONIC HEART-FAILURE - A PROSPECTIVE-STUDY IN 406 PATIENTS", European heart journal, 17(9), 1996, pp. 1381-1389

Abstract

In patients with heart failure the risk of systemic thromboembolism and the benefit of anticoagulation are uncertain. To assess the incidence of systemic thromboembolism and the factors associated with an increased risk, 406 consecutive patients with chronic heart failure were prospectively investigated. Their left ventricular ejection fraction was 23 +/- 8%, pulmonary wedge pressure 19 +/- 10 mmHg and cardiac index2.3 +/- 1.41 . min(-1). m(-2) of body surface area. Two hundred patients were in NYHA functional class III-IV. Two hundred and thirty-two patients were receiving oral anticoagulants. Over a follow-up period of16+/-11 months, thromboembolism occurred in 11 patients (2.7%), sevenof whom were on anticoagulants. Among clinical, echocardiographic andhaemodynamic variables, atrial fibrillation, more severe haemodynamicimpairment and low exercise capacity were associated with increased thromboembolic risk. No echocardiographic findings, including the presence of intracavitary thrombi, either at baseline or during follow-up, were related to subsequent thromboembolic events. The rate of embolismdid not differ in patients receiving anticoagulants (4%) compared with those who did not receive anticoagulants (1%). No major bleeding occurred during follow-up. Thus, in patients with chronic heart failure and sinus rhythm the incidence of systemic thromboembolism is low regardless of anticoagulant treatment. Atrial fibrillation, particularly when associated with low cardiac index, identifies a subgroup of patients at high risk of events. In this subgroup, a moderate-intensity anticoagulant regimen provides unsatisfactory protection against thromboembolism.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 19:46:54