Does HF severity affect Warfarin control?

What is it about?

Anticoagulation is recommended in select patients with heart failure (HF). In this setting, warfarin remains a common choice for anticoagulation, necessitating periodic to adjust dosage. Previous studies show having heart failure would impact the quality of anticoagulation. However, the knowledge is limited regarding the severity of heart failure and the quality of anticoagulation. In this investigation, we found that more severe NYHA class, poor health-related quality of life and a higher rate of HF hospitalization were independently associated with suboptimal quality of warfarin anticoagulation control.

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Why is it important?

Direct oral anticoagulants (DOACs) has been proposed to replace warfarin as DOACs have favorable risk-benefit profiles. However, the effects of DOACs in HF patients have not known. Given that optimal warfarin anticoagulation may be difficult to achieve especially in patients with more severe HF, our results also affirms the need to assess the effect of DOACs in this population, such as through the ongoing COMMANDER HF trial, which seeks to assess the effectiveness and safety of rivaroxaban in reducing the risk of death, myocardial infarction or stroke in participants with HF and coronary artery disease following an episode of decompensated HF

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