המידע באדיבות medicontext.co.il
Last Updated: 2001-08-10 14:21:14 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) – Patients with congestive heart failure (CHF) may benefit from prophylactic anticoagulation therapy, according to a new study that links CHF to a near 40-fold increased risk of deep venous thromboembolism (DVT) in some patients.
"Our results substantiate clinicians' long-held belief that patients with CHF are more likely to develop deep venous thrombosis and pulmonary embolism," Dr. A. A. Knowlton, of the Veterans Affairs Medical Center, in Houston, Texas, and multicenter colleagues report in the August issue of the Journal of Clinical Epidemiology. "For many years, inpatients with CHF have been considered at increased risk of venous thromboembolism and prophylaxis is recommended for them."
Despite this practice, the strength of the link between CHF and DVT has not been directly studied until now. Dr. Knowlton's group examined the association between CHF and DVT in a retrospective case-control study of 106 patients with DVT and 603 controls. All subjects were inpatients at the VA Medical Center; controls were admitted for diabetes or infection.
After controlling for other potential risk factors, CHF was a strong independent predictor of venous thromboembolism. This risk was particularly pronounced in patients with an ejection fraction below 20%, for whom the odds of venous thromboembolism were increased nearly 40-fold. Overall, the link between CHF and venous thromboembolism was ejection fraction-dependent.
"Our findings provide evidence supporting the practice of chronic anticoagulation in selected patients with CHF, particularly when taken in concert with previous work suggesting decreased all-cause mortality in CHF patients on warfarin," the Texas-based researchers conclude.
J Clin Epidemiol 2001;54:810-816.
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