Why the study?
Patients with chronic HF face thromboembolic risks, but there is wide variation in the indications and use of oral anticoagulation in the broader HF population beyond AF.
Systematic Review (n=5,498)
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No mortality benefit supports avoiding routine anticoagulation in HF with sinus rhythm; confirms null effect across prior RCTs.
People with chronic heart failure (HF) are at risk of thromboembolic events, including stroke, pulmonary embolism, and peripheral arterial embolism; coronary ischaemic events also contribute to the progression of HF. The use of long-term oral anticoagulation is established in certain populations, including people with HF and atrial fibrillation (AF), but there is wide variation in the indications and use of oral anticoagulation in the broader HF population.
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Shantsila et al. (2021) conducted a systematic review in Heart failure in sinus rhythm (n=5,498). Oral anticoagulants (Rivaroxaban, Warfarin) vs. Placebo or no treatment was evaluated on All-cause death (Rivaroxaban vs Placebo) (OR 0.99, 95% CI 0.87 to 1.13).
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