ReviewClinical research in cardiology : official journal of the German Cardiac Society2022
Anticoagulants for stroke prevention in heart failure with reduced ejection fraction.
Review in Clinical research in cardiology : official journal of the German Cardiac Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Apixaban and Recurrent Stroke Risk With Left Ventricular Dysfunction: A Secondary Analysis of the ARCADIA Trial.Stroke · 2025Trial
- Investigation of Atrial and Ventricular Arrhythmias in Young Ischemic Cerebrovascular Disease Patients.International journal of general medicine · 2026Article
- MiR-150-5p attenuates heart failure by targeting MMP14 to regulate vascular smooth muscle cell function.Molecular and cellular biochemistry · 2026Article
- Association between estimated glomerular filtration rate, urinary albuminuria-creatinine ratio, and stroke prevalence in patients with chronic kidney disease.Renal failure · 2025Article
- Unravelling the role of electrocardiogram changes and ejection fraction in ischaemic stroke outcomes.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025Review
- Stroke prediction in elderly patients with atrial fibrillation using machine learning combined clinical and left atrial appendage imaging phenotypic features.BMC cardiovascular disorders · 2025Article
- Analysis of prognostic differences and risk factors in patients with atrial fibrillation known before ischemic stroke and atrial fibrillation diagnosed after ischemic stroke.Journal of neurology · 2025Article
- Intersections and Challenges in the Management of Acute Coronary Syndrome and Stroke: Pathophysiology, Treatment Dilemmas, and Integrated Prevention Strategies.Journal of clinical medicine · 2025Review
- Review
- Effect of Left Ventricular Systolic Dysfunction on the Outcome of Mechanical Thrombectomy.Journal of neuroendovascular therapy · 2025Article
- Cardioembolic stroke in an HIV endemic region: underdiagnosed and severe.BMJ neurology open · 2024Article
- Stroke and Recent Myocardial Infarction, Reduced Left Ventricular Ejection Fraction, Left Ventricular Thrombus, and Wall Motion Abnormalities.Current cardiology reports · 2023Review
- Left Ventricular Ejection Fraction Association with Acute Ischemic Stroke Outcomes in Patients Undergoing Thrombolysis.Journal of cardiovascular development and disease · 2023Article
- Genetic Risk Score Improves Risk Stratification for Anticoagulation-Related Intracerebral Hemorrhage.Stroke · 2023Article
- Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Impaired left-ventricular ejection-fraction (LV-EF) is a known risk factor for ischemic stroke and systemic embolism in patients with heart failure (HF) even in the absence of atrial fibrillation. While stroke risk is inversely correlated with LV-EF in HF patients with sinus rhythm, strategies using anticoagulation with Vitamin-K antagonists (VKA) were futile as the increase in major bleedings outweighed the potential benefit in stroke reduction. Non-Vitamin K oral anticoagulants (NOACs) proved to be an effective and in general safer approach for stroke prevention in patients with atrial fibrillation and may also have a favourable risk-benefit profile in HF patients. In HF patients with sinus rhythm, the COMPASS trial suggested a potential benefit for rivaroxaban, whereas the more dedicated COMMANDER-HF trial remained neutral on overall ischemic benefit owed to a higher mortality which was not influenced by anticoagulation. More recent data from subgroups in the COMMANDER-HF trial, however, suggest that there might be a benefit of rivaroxaban regarding stroke prevention under certain circumstances. In this article, we review the existing evidence for NOACs in HF patients with atrial fibrillation, elaborate the rationale for stroke prevention in HF patients with sinus rhythm, summarise the available data from anticoagulation trials in HF with sinus rhythm, and describe the patient who might eventually profit from an individualised strategy aiming to reduce stroke risk.
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