Warfarin in Heart Failure

Despite major advances in the management of heart failure with angiotensin-converting–enzyme inhibitors, beta-blockers, and resynchronization therapy, there are more than 1 million hospitalizations for heart failure in the United States each year, and mortality remains high.1 As compared with the general population, patients with heart failure have an increased risk of stroke and of systemic thromboembolic events, which are believed to arise from within the heart as a result of left ventricular stasis, endocardial dysfunction, and a systemic hypercoagulable state.2 Heart failure is a risk factor for atrial fibrillation, which, even if asymptomatic, further increases the risk of stroke.3 Consequently, . . .