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September 21, 2006Current Medical Research and Opinion

Does heart failure exacerbation increase response to warfarin?A critical review of the literature

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Why the study?

Does heart failure exacerbation increase the response to warfarin?

Population

Patients with decompensated heart failure taking warfarin or other vitamin K antagonists

Design

Review

Key result

Heart failure exacerbations may be associated with an increased response to warfarin, though evidence is limited by small patient populations and inadequate reports.

Authors

TSTimothy H. SelfARAnne B. ReavesCOCarrie S. Oliphant

Discussion

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Overview

May warrant cautious INR monitoring in decompensated HF; leaves open confirmation via prospective studies.

Structured PICO

Does heart failure exacerbation increase the response to warfarin?

P
Population
Patients with decompensated heart failure taking warfarin or other vitamin K antagonists
E
Exposure
Decompensated heart failure / heart failure exacerbation
O
Outcome
Response to warfarin (e.g., INR changes, dose requirements)surrogate

Heart failure exacerbations may increase patient sensitivity to warfarin, suggesting a need for lower starting doses and more frequent INR monitoring during periods of instability.

Limitations

  • Early reports have important limitations
  • Small patient populations in recent reports
  • Many reports are inadequate
  • Large number of variables impact warfarin dose requirement

Cite This Study

Self et al. (2006) conducted a review in Decompensated heart failure. Heart failure exacerbation was evaluated on Response to warfarin. Heart failure exacerbations may be associated with an increased response to warfarin, though evidence is limited by small patient populations and inadequate reports.

synapsesocial.com/papers/6a20b1d4e2a660d176234933https://doi.org/10.1185/030079906x132479
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