Topics


Low Ejection Fraction and Anticoagulation

Paper
Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis
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A review and meta-analysis of five trials evaluating stroke prevention in HFrEF using anticoagulation vs antiplatelet or placebo groups, finding no significant overall reduction in all cause mortality. A reduction in non-fatal ischemic stroke was offset by an increase in major hemorrhage with anticoagulation use.
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(WARCEF) Warfarin and Aspirin in Patients with Heart Failure and Sinus Rhythm
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A RCT comparing warfarin to aspirin for stroke prevention in HFrEF patients in sinus rhythm, finding no significant difference in time to a composite of stroke/ICH/death. Warfarin was associated with significant ischemic stroke reduction, offset by increased significant major hemorrhage.
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(COMMANDER HF) Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease
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A RCT comparing rivaroxaban 2.5 mg BID to placebo in patients with HFrEF and CAD without history of A fib, finding no significant difference between groups in the composite of death/MI/stroke, or all cause mortality, or major bleeding.
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Left Ventricular Dysfunction Among Patients with Embolic Stroke of Undetermined Source and the Effect of Rivaroxaban vs Aspirin: A Subgroup Analysis of the Navigate ESUS Randomized Clinical Trial
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A post-hoc analysis of the NAVIGATE ESUS trial assessing for treatment interaction for patients randomized to rivaroxaban 15 mg vs aspirin by LV dysfunction status, finding that in patients with LV dysfunction, rivaroxaban significantly reduced the risk of stroke or systemic embolism
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