Meta-Analysis Of Anticoagulant Therapy For Chronic Heart Failure

BackgroundChronic heart failure patients exist hypercoagulable states.Enough evidences of large therapeutic heart failure trials has estimated the probability of thromboembolism events in chronic heart failure patients is very high,to be between 1 and 4.5%.And Rudolf Virchow had definited chronic heart failure as pre- thromboembolism states due to chronic heart failure patients exist abnormal blood flow,abnormalities in the vessel wall and abnormalities in the blood constituents.But compared with antipatelet therapy or placebo,the evidence for anticoagulation therapy in chronic heart failure patients is still limited. So anticoagulant therapy can't be as the routine treatment for chronic heart failure.ObjectiveTo estimate anticoagulant therapy is beneficial for chronc heart failure or not by Meta-analysisMethodsMeta—analysis was performed by using RevMan 4.2 software to analyse choosed 10 RCTs which about mortality and thromboembolism events by anticoagulant therapy and antipatelet therapy or placebo in chronic heart failure.ResultsTen RCTs including 640 chronic heart failure patients were included.Significant heterogeneity(I2=80.2%, P＜0.00001) was found when the data were pooled.So a random efect model was used for meta—analysis. Compared with placebo or antipatelet therapy, the anticoagulant therapy decrease the incidence rate of mortality and thromboembolism events (Z=2.6, P=0.009), combined OR is 0.62,95%CI(0.77, 0.98), P=0.009.Risk difference is -0.04 (-0.07,-0.01).The fail—safe number was 93.75.ConclusionsThe result of Meta-analysis showed that anticoagulant therapy could decrease the incidence rate of mortality and thromboembolism events in chronic heart failure patients.