Abstract 17595: Warfarin versus Aspirin for Heart Failure in Sinus Rhythm: A Systematic Review and Meta-Analysis
Purpose: Patients with heart failure are at risk of thromboembolic events which in turn contribute to the high mortality and morbidity in heart failure. We conducted a meta-analysis of all randomized studies to determine the effect of warfarin when compared to aspirin on all-cause mortality, stroke, myocardial infarction, hospitalizations and major bleedings in heart failure patients who are in sinus rhythm.
Methods: A comprehensive search of electronic databases was conducted through May 2012. Randomized controlled studies comparing warfarin with aspirin were included.
Results: All the 4 studies included (3,663 participants, mean follow-up 2.3 years) reported results on all-cause mortality, stroke, myocardial infarction, hospitalizations and major bleedings. The pooled relative risks (RRs) for the abovementioned endpoints were 1.01 (95% CI: 0.86 to 1.19), 0.50 (95% CI: 0.34 to 0.75), 1.01 (95% CI: 0.69 to 1.48), 0.88 (95% CI: 0.63 to 1.22), and 1.95 (95% CI: 1.40 to 2.71), respectively, for use of warfarin versus use of aspirin.
Conclusions: Use of warfarin reduces the risk of stroke in half in patients with heart failure in sinus rhythm, but doubles their risk for major bleedings compared to aspirin. Use of warfarin or aspirin share similar risks for all-cause mortality, myocardial infarction and hospitalizations in this population.
- © 2012 by American Heart Association, Inc.