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Gaceta Médica Boliviana

Print version ISSN 1012-2966On-line version ISSN 2227-3662

Abstract

MALDONADO VILLEGAS, Alejandra  and  MERCADO MALDONADO, Luis. Oral anticoagulation on patients with chronic hearth failure with reduced ejection fraction, experience at Centro Médico Quirúrgico Boliviano Belga. Gac Med Bol [online]. 2013, vol.36, n.2, pp.64-67. ISSN 1012-2966.

Objectives: to describe warfarin use and the incidence of stroke and mortality in chronic hearth failure with reduced ejection fraction (HFrEF) at Centro Médico Quirúrgico Boliviano Belga between 2004 and 2011. Methods: descriptive and transversal study in > 18 years with symptomatic ICC-FER, dividing them into those with sinus rhythm and non-valvular atrial fibrillation (NVAF), excluding those with intracavitary thrombus, recent thromboembolism, prosthetic valve and requiring the implant during the study. Results: 46 patients with sinus rhythm and 18 with NVAF. 46 patients with sinus rhythm and 18 with NVAF with severely reduced ejection fraction in both groups (29% and 30% respectively), all with diuretics and disease modifiers. All NVAF patients received antithrombotic therapy (anticoagulant and/or antiplatelet agents), 94% indicating anticoagulation as VASc CHA2DS2 were medicated with warfarin.). All the patients with NVAF received antithrombotics (anticoagulants and/or and antiplatelet drugs), 94% of which required anticoagulation according to CHA2DS2 VASc, they were medicated with warfarin. 67% of patients with sinus rhythm were anticoagulated whilst 6,5% were not. The stroke incidence were of 0,11 in NVAF and 0,15 in sinus rhythm during a 3 year monitoring period, whilst mortality reached 40% and 42% respectively in an average period of 4 years (+1,2). Conclusions: in HFrEF and NVFA most patients where receiving warfarin, that in this group had high embolic risk. Oral anticoagulation with warfarin in chronic heart failure with severely compromised FE (< 30%) in sinus rhythm often, without reporting major complications. The incidence of stroke was low and the overall mortality was high.

Keywords : heart failure; anticoagulants; atrial fibrillation.

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