心力衰竭患者高凝状态与抗栓治疗

心力衰竭(HF)患者脑卒中、肺栓塞及外周静脉血栓等血栓栓塞事件的发生率明显高于非HF患者。其抗栓治疗一直存在争议,主要权衡抗栓(抗凝和抗血小板)治疗、血栓栓塞风险降低的获益和出血的风险。多项研究已证实,有心房颤动或血栓栓塞史的HF患者需要进行常规抗凝治疗,但窦性心律HF患者是否需要进行预防性抗栓治疗目前还没有达成共识。

Hypercoagulability and antithrombotic therapy in heart failure patients

Patients with heart failure(HF) have a higher prevalence of thromboembolism events,including stroke,pulmonary embolism and venous thromboembolism.However,the role of antithrombotic therapy in patients with HF has long been debated.It is hard to balance the benefits of antithrombotic(anticoagulation and antiplatelet) therapy and bleeding risk.Routine anticoagulation therapy is justified in patients with HF who have atrial fibrillation or who have experienced a previous embolic event by several trials.But there is limited evidence to advocate prophylactic antithrombotic therapy for patients with HF in sinus rhythm.