Advances in Heart Failure Thromboembolism and Antithrombotic Therapy in Patients With Heart Failure in Sinus Rhythm Current Status and Future Directions

Heart failure (HF) represents a major and growing publichealth problem because of its prevalence, incidence, morbidity, mortality, and economic costs. The prevalence of HF is 2 % to 3 % of the general population.1 Five million Americans are affected, with550 000 cases diagnosed each year.2 The mortality rate from severe HF remains 60% within 5 years of diagnosis, and 50 % of hospitalized patients with HF require readmission within 6 months of discharge. In the US estimated costs amount to $35 billion per year.3 Although several therapies (eg, -blockers, angiotensin-converting enzyme [ACE] inhibitors, and cardiac resynchro-nization therapy) have been proven effective in improving HF outcomes, many unanswered questions about optimal treat-ment remain. One area of ongoing uncertainty is the appro-priate role for antithrombotic therapy in patients with HF. Observational data suggest that patients with HF have a