Incidence of thromboembolic events in congestive heart failure

W. B. Dunkman, G. R. Johnson, P. E. Carson, G. Bhat, L. Farrell, Jay N Cohn

Research output: Contribution to journalArticle

246 Citations (Scopus)

Abstract

Background. The incidence of thromboembolism and the benefit of anticoagulation in congestive heart failure are controversial. Methods and Results. The data base provided by the Veterans Affairs Vasodilator-Heart Failure Trials (V-HeFT I and II) was examined retrospectively to address these issues. In V-HeFT I, 642 men with heart failure were followed an average of 2.28 years, providing 1,464 patient-years of follow-up. In V-HeFT II, 804 men were followed an average of 2.56 years, with 2,061 patient-years of follow-up. Mean left ventricular ejection fraction was 30% in V-HeFT I and 29% in V-HeFT II. Functional capacity was at the interface of classes II and III with a peak exercise oxygen consumption of 14.7 mL · kg-1 · min-1 in V-HeFT I and 13.7 mL · kg-1 · min-1 in V-HeFT II. Warfarin and antiplatelet agents were administered at the discretion of individual investigators. The incidence of all thromboembolic events during 1,068 patient-years without warfarin in V-HeFT I was 2.7/100 patient-years and during 1,188 patient-years in V-HeFT II was 2.1/100 patient-years and was not reduced in patients treated with warfarin. Patients experiencing events had a lower peak exercise oxygen consumption (p<0.03 in V-HeFT I and p<0.001 in V- HeFT II) and a lower mean ejection fraction (p=0.10 in V-HeFT I and p=0.07 in V-HeFT II). Atrial fibrillation was not associated with an increased risk of thromboembolic events. Conclusions. The incidence of thromboembolism and stroke in class II or III congestive heart failure is not high and may not be significantly reduced with warfarin treatment. Routine use of anticoagulants in patients with heart failure may not be justified.

Original languageEnglish (US)
JournalCirculation
Volume87
Issue number6 SUPPL. VI
StatePublished - Jan 1 1993
Externally publishedYes

Fingerprint

Heart Failure
Incidence
Warfarin
Thromboembolism
Oxygen Consumption
Exercise
Platelet Aggregation Inhibitors
Veterans
Vasodilator Agents
Stroke Volume
Anticoagulants
Atrial Fibrillation
Stroke
Research Personnel
Databases

Keywords

  • anticoagulation
  • antiplatelets
  • stroke
  • thromboembolism

Cite this

Dunkman, W. B., Johnson, G. R., Carson, P. E., Bhat, G., Farrell, L., & Cohn, J. N. (1993). Incidence of thromboembolic events in congestive heart failure. Circulation, 87(6 SUPPL. VI).

Incidence of thromboembolic events in congestive heart failure. / Dunkman, W. B.; Johnson, G. R.; Carson, P. E.; Bhat, G.; Farrell, L.; Cohn, Jay N.

In: Circulation, Vol. 87, No. 6 SUPPL. VI, 01.01.1993.

Research output: Contribution to journalArticle

Dunkman, WB, Johnson, GR, Carson, PE, Bhat, G, Farrell, L & Cohn, JN 1993, 'Incidence of thromboembolic events in congestive heart failure', Circulation, vol. 87, no. 6 SUPPL. VI.
Dunkman WB, Johnson GR, Carson PE, Bhat G, Farrell L, Cohn JN. Incidence of thromboembolic events in congestive heart failure. Circulation. 1993 Jan 1;87(6 SUPPL. VI).
Dunkman, W. B. ; Johnson, G. R. ; Carson, P. E. ; Bhat, G. ; Farrell, L. ; Cohn, Jay N. / Incidence of thromboembolic events in congestive heart failure. In: Circulation. 1993 ; Vol. 87, No. 6 SUPPL. VI.
@article{966fbf5613f24d74b0024e4feca3079f,
title = "Incidence of thromboembolic events in congestive heart failure",
abstract = "Background. The incidence of thromboembolism and the benefit of anticoagulation in congestive heart failure are controversial. Methods and Results. The data base provided by the Veterans Affairs Vasodilator-Heart Failure Trials (V-HeFT I and II) was examined retrospectively to address these issues. In V-HeFT I, 642 men with heart failure were followed an average of 2.28 years, providing 1,464 patient-years of follow-up. In V-HeFT II, 804 men were followed an average of 2.56 years, with 2,061 patient-years of follow-up. Mean left ventricular ejection fraction was 30{\%} in V-HeFT I and 29{\%} in V-HeFT II. Functional capacity was at the interface of classes II and III with a peak exercise oxygen consumption of 14.7 mL · kg-1 · min-1 in V-HeFT I and 13.7 mL · kg-1 · min-1 in V-HeFT II. Warfarin and antiplatelet agents were administered at the discretion of individual investigators. The incidence of all thromboembolic events during 1,068 patient-years without warfarin in V-HeFT I was 2.7/100 patient-years and during 1,188 patient-years in V-HeFT II was 2.1/100 patient-years and was not reduced in patients treated with warfarin. Patients experiencing events had a lower peak exercise oxygen consumption (p<0.03 in V-HeFT I and p<0.001 in V- HeFT II) and a lower mean ejection fraction (p=0.10 in V-HeFT I and p=0.07 in V-HeFT II). Atrial fibrillation was not associated with an increased risk of thromboembolic events. Conclusions. The incidence of thromboembolism and stroke in class II or III congestive heart failure is not high and may not be significantly reduced with warfarin treatment. Routine use of anticoagulants in patients with heart failure may not be justified.",
keywords = "anticoagulation, antiplatelets, stroke, thromboembolism",
author = "Dunkman, {W. B.} and Johnson, {G. R.} and Carson, {P. E.} and G. Bhat and L. Farrell and Cohn, {Jay N}",
year = "1993",
month = "1",
day = "1",
language = "English (US)",
volume = "87",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "6 SUPPL. VI",

}

TY - JOUR

T1 - Incidence of thromboembolic events in congestive heart failure

AU - Dunkman, W. B.

AU - Johnson, G. R.

AU - Carson, P. E.

AU - Bhat, G.

AU - Farrell, L.

AU - Cohn, Jay N

PY - 1993/1/1

Y1 - 1993/1/1

N2 - Background. The incidence of thromboembolism and the benefit of anticoagulation in congestive heart failure are controversial. Methods and Results. The data base provided by the Veterans Affairs Vasodilator-Heart Failure Trials (V-HeFT I and II) was examined retrospectively to address these issues. In V-HeFT I, 642 men with heart failure were followed an average of 2.28 years, providing 1,464 patient-years of follow-up. In V-HeFT II, 804 men were followed an average of 2.56 years, with 2,061 patient-years of follow-up. Mean left ventricular ejection fraction was 30% in V-HeFT I and 29% in V-HeFT II. Functional capacity was at the interface of classes II and III with a peak exercise oxygen consumption of 14.7 mL · kg-1 · min-1 in V-HeFT I and 13.7 mL · kg-1 · min-1 in V-HeFT II. Warfarin and antiplatelet agents were administered at the discretion of individual investigators. The incidence of all thromboembolic events during 1,068 patient-years without warfarin in V-HeFT I was 2.7/100 patient-years and during 1,188 patient-years in V-HeFT II was 2.1/100 patient-years and was not reduced in patients treated with warfarin. Patients experiencing events had a lower peak exercise oxygen consumption (p<0.03 in V-HeFT I and p<0.001 in V- HeFT II) and a lower mean ejection fraction (p=0.10 in V-HeFT I and p=0.07 in V-HeFT II). Atrial fibrillation was not associated with an increased risk of thromboembolic events. Conclusions. The incidence of thromboembolism and stroke in class II or III congestive heart failure is not high and may not be significantly reduced with warfarin treatment. Routine use of anticoagulants in patients with heart failure may not be justified.

AB - Background. The incidence of thromboembolism and the benefit of anticoagulation in congestive heart failure are controversial. Methods and Results. The data base provided by the Veterans Affairs Vasodilator-Heart Failure Trials (V-HeFT I and II) was examined retrospectively to address these issues. In V-HeFT I, 642 men with heart failure were followed an average of 2.28 years, providing 1,464 patient-years of follow-up. In V-HeFT II, 804 men were followed an average of 2.56 years, with 2,061 patient-years of follow-up. Mean left ventricular ejection fraction was 30% in V-HeFT I and 29% in V-HeFT II. Functional capacity was at the interface of classes II and III with a peak exercise oxygen consumption of 14.7 mL · kg-1 · min-1 in V-HeFT I and 13.7 mL · kg-1 · min-1 in V-HeFT II. Warfarin and antiplatelet agents were administered at the discretion of individual investigators. The incidence of all thromboembolic events during 1,068 patient-years without warfarin in V-HeFT I was 2.7/100 patient-years and during 1,188 patient-years in V-HeFT II was 2.1/100 patient-years and was not reduced in patients treated with warfarin. Patients experiencing events had a lower peak exercise oxygen consumption (p<0.03 in V-HeFT I and p<0.001 in V- HeFT II) and a lower mean ejection fraction (p=0.10 in V-HeFT I and p=0.07 in V-HeFT II). Atrial fibrillation was not associated with an increased risk of thromboembolic events. Conclusions. The incidence of thromboembolism and stroke in class II or III congestive heart failure is not high and may not be significantly reduced with warfarin treatment. Routine use of anticoagulants in patients with heart failure may not be justified.

KW - anticoagulation

KW - antiplatelets

KW - stroke

KW - thromboembolism

UR - http://www.scopus.com/inward/record.url?scp=0027294783&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027294783&partnerID=8YFLogxK

M3 - Article

C2 - 8500246

AN - SCOPUS:0027294783

VL - 87

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 6 SUPPL. VI

ER -