Coagulation Abnormalities in Heart Failure: Pathophysiology and Therapeutic Implications

Ju H. Kim, Palak Shah, Udaya S. Tantry, Paul A. Gurbel

Research output: Contribution to journalReview article

Abstract

Heart failure (HF) represents a heterogeneous condition characterized by vulnerabilities in the blood, vasculature, and impaired flow dynamics that predispose to both arterial and venous thrombosis. Despite evidence-based advances in the medical and device management of chronic HF, it remains a leading cause of morbidity and mortality in the USA due to repeat hospitalizations and comorbid conditions such as atrial fibrillation (AF) and stroke. The presence of platelet activation and hypercoagulability in HF has been well documented. Anticoagulation is effective in HF when comorbidities such as AF and prior venous thromboembolism exist. However, data is less clear for HF in sinus rhythm. Moreover, there is a paucity of data regarding antiplatelet therapy in HF. No consensus guidelines exist regarding the precise role of antiplatelet or antithrombotic therapy in HF. This review addresses the pathophysiology of coagulation abnormalities in HF, examines the available evidence regarding the use of anticoagulants and antiplatelet agents in HF, and discusses its therapeutic implications.

Original languageEnglish (US)
Pages (from-to)319-328
Number of pages10
JournalCurrent Heart Failure Reports
Volume13
Issue number6
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Keywords

  • Anticoagulants
  • Antiplatelets
  • Atrial fibrillation
  • Heart failure
  • Thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Emergency Medicine

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