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Current practice and effects of intravenous anticoagulant therapy in hospitalized acute heart failure patients with sinus rhythm

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Title: Current practice and effects of intravenous anticoagulant therapy in hospitalized acute heart failure patients with sinus rhythm
Authors: Nakano, Hiroki Browse this author
Hamatani, Yasuhiro Browse this author
Nagai, Toshiyuki Browse this author →KAKEN DB
Nakai, Michikazu Browse this author
Nishimura, Kunihiro Browse this author
Sumita, Yoko Browse this author
Ogawa, Hisao Browse this author
Anzai, Toshihisa Browse this author
Issue Date: 13-Jan-2021
Publisher: Nature Research
Journal Title: Scientific reports
Volume: 11
Start Page: 1202
Publisher DOI: 10.1038/s41598-020-79700-5
PMID: 33441666
Abstract: Although the risk of thromboembolism is increased in heart failure (HF) patients irrespective of atrial fibrillation (AF), especially during the acute decompensated phase, the effects of intravenous anticoagulants for these patients remain unclear. We sought to investigate the current practice and effects of intravenous anticoagulant therapy in acute HF (AHF) patients with sinus rhythm. We analyzed a nationwide prospective cohort from April 2012 to March 2016. We extracted 309,015 AHF adult patients. After application of the exclusion criteria, we divided the 92,573 study population into non-heparin [n=70,621 (76.3%)] and heparin [n=21,952 (23.7%)] groups according to the use of intravenous heparin for the first 2 consecutive days after admission. Multivariable logistic regression analyses demonstrated that heparin administration was not associated with in-hospital mortality (OR 0.97, 95% CI 0.91-1.03) and intracranial hemorrhage (OR 1.18, 95% CI 0.78-1.77), while heparin administration was significantly associated with increased incidence of ischemic stroke (OR 1.49, 95% CI 1.29-1.72) and venous thromboembolism (OR 1.62, 95% CI 1.14-2.30). In conclusion, intravenous heparin administration was not associated with favorable in-hospital outcomes in AHF patients with sinus rhythm. Routine additive use of intravenous heparin to initial treatment might not be recommended in AHF patients.
Publisher URI: https://doi.org/10.1038/s41598-020-79700-5
Type: article
URI: http://hdl.handle.net/2115/81044
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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