What is the clinical evidence from this study?

Study design: Cohort. Population: Left ventricular (LV) dysfunction (n=6797). Intervention: Warfarin anticoagulation vs. No warfarin use. Primary outcome: All-cause mortality (HR 0.76, 95% CI 0.65-0.89, p=0.0006).

What does this research mean for the field?

Warfarin use in patients with left ventricular systolic dysfunction is associated with a significant reduction in all-cause mortality and heart failure hospitalization. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the association between warfarin anticoagulation and survival as well as cardiac morbidity in patients with left ventricular systolic dysfunction.

August 17, 2026Journal of the American College of CardiologyOpen Access

Warfarin Anticoagulation and Survival: A Cohort Analysis From the Studies of Left Ventricular Dysfunction 11This study was supported by Grant MO1-RR00054 from the General Clinical Research Center, funded by the Division of Research Resources, National Institutes of Health, Bethesda, Maryland. The Studies of Left Ventricular Dysfunction (SOLVD) were funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, with a contribution from Merck, Sharpe and Dohme Pharmaceutical Company, West Point, Pennsylvania.

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Key result

Warfarin use in LVSD is linked to ~24% lower all-cause mortality.

HR 0.76
95% CI 0.65-0.89
P=0.0006
n=6,797

Why the study?

Warfarin anticoagulation plays a major role after large myocardial infarction and in atrial fibrillation, but its use in patients with LV systolic dysfunction has been controversial.

Does warfarin reduce all-cause mortality in patients with left ventricular systolic dysfunction?

Population

6,797 patients with LV dysfunction enrolled in the SOLVD trial

Comparison

Warfarin use vs no warfarin use

Design

Cohort analysis of clinical trial data

Authors

AAAyman S. Al-KhadraPrince Sultan University DSDeeb N. SalemCardiac Imaging WRWilliam RandNorth Carolina State University

Discussion

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Implication

In patients with LV systolic dysfunction, warfarin use is associated with improved survival and reduced morbidity.

Key Points

To evaluate the association between warfarin anticoagulation and survival as well as cardiac morbidity in patients with left ventricular systolic dysfunction.
Analyzed data on warfarin therapy among 6,797 patients enrolled in the Studies of Left Ventricular Dysfunction (SOLVD) trial.
Applied multivariable Cox regression models to control for baseline confounding and to evaluate interactions across clinical subgroups.
Warfarin use was associated with a significant reduction in all-cause mortality (adjusted HR 0.76, 95% CI 0.65 to 0.89, p = 0.0006).
Warfarin therapy significantly reduced the composite outcome of death or heart failure hospitalization (adjusted HR 0.82, 95% CI 0.72 to 0.93, p = 0.0002).
Survival and morbidity benefits remained consistent across both genders, trial arms, and regardless of atrial fibrillation status, ejection fraction, NYHA class, or heart failure etiology.

Study Design

Type

Cohort (n=6,797)

Structured PICO

Does warfarin reduce all-cause mortality in patients with left ventricular systolic dysfunction?

Population

6,797 patients with left ventricular systolic dysfunction enrolled in the SOLVD trial.

Exposure

Warfarin

Comparator

No warfarin (adjusted for baseline characteristics)

Outcome

All-cause mortalityhard clinical

Main Result

Hazard Ratio: 0.76 (95% CI 0.65–0.89)

p-value: p=0.0006

In patients with LV systolic dysfunction, warfarin use is associated with improved survival and reduced morbidity.

Cite This Study

Al-Khadra et al. (1998) conducted a cohort in Left ventricular (LV) dysfunction (n=6,797). Warfarin anticoagulation vs. No warfarin use was evaluated on All-cause mortality (HR 0.76, 95% CI 0.65-0.89, p=0.0006). Warfarin use in patients with left ventricular systolic dysfunction was associated with a significant reduction in all-cause mortality (adjusted HR 0.76; 95% CI 0.65-0.89; p=0.0006).

synapsesocial.com/papers/6a837ac2ec361eff96a61a1f https://doi.org/10.1016/s0735-1097(98)00006-0

Topics

Women and heart disease

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Discussion

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Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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Discussion

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Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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