Extended thromboprophylaxis in heart failure patients; the unmet need.

Autor: Al Yami MS; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia. yamim@ksau-hs.edu.sa.; King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia. yamim@ksau-hs.edu.sa.; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. yamim@ksau-hs.edu.sa., Alshehri AM; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia.; King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia., Alay SM; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia., Aljoufi AY; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia., Alsulimani MS; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia., Algarni SM; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia., Almohareb SN; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia.; King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia., Hafiz AM; Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia., Alshaya OA; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia.; King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia., Badawoud AM; Princess Nourah bint Abdulrahman University, College of Pharmacy, Department of Pharmacy Practice, Riyadh, Saudi Arabia.
Jazyk: angličtina
Zdroj: Heart failure reviews [Heart Fail Rev] 2024 Sep; Vol. 29 (5), pp. 1107-1116. Date of Electronic Publication: 2024 Jul 17.
DOI: 10.1007/s10741-024-10422-w
Abstrakt: 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.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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