Majed S Al Yami, Abdulmajeed M Alshehri, Saeed M Alay, Abdulmalik Y Aljoufi, Mariam S Alsulimani, Shatha M Algarni, Sumaya N Almohareb, Awatif M Hafiz, Omar A Alshaya, Amal M Badawoud
{"title":"心力衰竭患者的长期血栓预防;尚未满足的需求。","authors":"Majed S Al Yami, Abdulmajeed M Alshehri, Saeed M Alay, Abdulmalik Y Aljoufi, Mariam S Alsulimani, Shatha M Algarni, Sumaya N Almohareb, Awatif M Hafiz, Omar A Alshaya, Amal M Badawoud","doi":"10.1007/s10741-024-10422-w","DOIUrl":null,"url":null,"abstract":"<p><p>Heart failure (HF) is considered one of a leading cause of cardiovascular morbidity and mortality worldwide. The association between HF and venous thromboembolism (VTE) has been reported in several studies owing to many physiological and thromboembolic risk factors. Thus, the need for extended thromboprophylaxis during the post-discharge period in HF patients has been evaluated. Most guidelines do not recommend extended thromboprophylaxis because of its uncertain benefits and increased risk of bleeding. However, recent evidence in HF patients revealed no increased risk of bleeding with extended thromboprophylaxis, which highlights the importance of identifying ideal candidates who might benefit from extended thromboprophylaxis. Several risk assessment models (RAMs) have been developed to identify patients at a high risk of VTE who would benefit from in-hospital and post-discharge prophylactic anticoagulation therapy based on the risk-benefit principle. However, their accuracy in predicting VTE is questionable, and none have a standardized approach for evaluating the risk of VTE in HF patients. In this review, we provided an overview of the incidence and pathophysiology of VTE in HF patients, a summary of guideline recommendations for VTE prevention, and a summary of studies evaluating the use of extended thromboprophylaxis, with a focus on subgroup or post-hoc analyses of HF patients. We also discussed the need to design an ideal RAM that can identify candidate patients for extended thromboprophylaxis by stratifying the risk of VTE and identifying the key risk factors for bleeding in medically ill patients, including those with HF.</p>","PeriodicalId":12950,"journal":{"name":"Heart Failure Reviews","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Extended thromboprophylaxis in heart failure patients; the unmet need.\",\"authors\":\"Majed S Al Yami, Abdulmajeed M Alshehri, Saeed M Alay, Abdulmalik Y Aljoufi, Mariam S Alsulimani, Shatha M Algarni, Sumaya N Almohareb, Awatif M Hafiz, Omar A Alshaya, Amal M Badawoud\",\"doi\":\"10.1007/s10741-024-10422-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Heart failure (HF) is considered one of a leading cause of cardiovascular morbidity and mortality worldwide. 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Extended thromboprophylaxis in heart failure patients; the unmet need.
Heart failure (HF) is considered one of a leading cause of cardiovascular morbidity and mortality worldwide. The association between HF and venous thromboembolism (VTE) has been reported in several studies owing to many physiological and thromboembolic risk factors. Thus, the need for extended thromboprophylaxis during the post-discharge period in HF patients has been evaluated. Most guidelines do not recommend extended thromboprophylaxis because of its uncertain benefits and increased risk of bleeding. However, recent evidence in HF patients revealed no increased risk of bleeding with extended thromboprophylaxis, which highlights the importance of identifying ideal candidates who might benefit from extended thromboprophylaxis. Several risk assessment models (RAMs) have been developed to identify patients at a high risk of VTE who would benefit from in-hospital and post-discharge prophylactic anticoagulation therapy based on the risk-benefit principle. However, their accuracy in predicting VTE is questionable, and none have a standardized approach for evaluating the risk of VTE in HF patients. In this review, we provided an overview of the incidence and pathophysiology of VTE in HF patients, a summary of guideline recommendations for VTE prevention, and a summary of studies evaluating the use of extended thromboprophylaxis, with a focus on subgroup or post-hoc analyses of HF patients. We also discussed the need to design an ideal RAM that can identify candidate patients for extended thromboprophylaxis by stratifying the risk of VTE and identifying the key risk factors for bleeding in medically ill patients, including those with HF.
期刊介绍:
Heart Failure Reviews is an international journal which develops links between basic scientists and clinical investigators, creating a unique, interdisciplinary dialogue focused on heart failure, its pathogenesis and treatment. The journal accordingly publishes papers in both basic and clinical research fields. Topics covered include clinical and surgical approaches to therapy, basic pharmacology, biochemistry, molecular biology, pathology, and electrophysiology.
The reviews are comprehensive, expanding the reader''s knowledge base and awareness of current research and new findings in this rapidly growing field of cardiovascular medicine. All reviews are thoroughly peer-reviewed before publication.