Meta-Analysis
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Feb 26, 2015; 3(1): 36-42
Published online Feb 26, 2015. doi: 10.13105/wjma.v3.i1.36
Antithrombotic treatment in chronic heart failure and sinus rhythm: Systematic review
Daniel Caldeira, Inês Cruz, Rita Calé, Cristina Martins, Helder Pereira, Joaquim J Ferreira, Fausto J Pinto, João Costa
Daniel Caldeira, Inês Cruz, Rita Calé, Cristina Martins, Helder Pereira, Cardiology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal
Daniel Caldeira, Joaquim J Ferreira, João Costa, Clinical Pharmacology Unit, Instituto de Medicina Molecular, 1649-028 Lisbon, Portugal
Daniel Caldeira, Joaquim J Ferreira, João Costa, Laboratory of Clinical Pharmacology, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
Fausto J Pinto, Cardiology Department, CCUL, CAML, Faculty of Medicine, 1649-028 Lisbon, Portugal
João Costa, Evidence Based Medicine Centre, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
João Costa, Portuguese Collaborating Centre of the Cochrane Iberoamerican Network, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
Author contributions: Caldeira D and Costa J contributed to the concept and design of the study and acquisition, analysis and interpretation of the data, wrote the first draft of the manuscript, critically revised the manuscript, and gave final approval of the submitted manuscript; Ferreira JJ and Pinto FJ contributed to the concept and design of the study and interpretation of the data, critically revised the manuscript, and gave final approval of the submitted manuscript; Cruz I, Calé R, Martins C and Pereira H contributed to interpretation of data, critically revised the manuscript, and gave final approval of the submitted manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Daniel Caldeira, Laboratory of Clinical Pharmacology, Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal. dgcaldeira@hotmail.com
Telephone: +351-21-7973453 Fax: +351-21-7819688
Received: May 20, 2014
Peer-review started: May 23, 2014
First decision: July 10, 2014
Revised: October 30, 2014
Accepted: November 17, 2014
Article in press: November 19, 2014
Published online: February 26, 2015
Core Tip

Core tip: In patients with atrial fibrillation, chronic heart failure (CHF) increases thromboembolic risk and oral anticoagulation is essential to decrease the risk of thromboembolic complications. Evidence suggests a positive association between CHF, impaired hemostasis and thromboembolic events. Whether antithrombotic drugs should be recommended for these patients (in sinus rhythm) is still debated. We looked for the best available evidence and we found 2 studies fulfilling the inclusion criteria. We performed a meta-analysis of antithrombotic drugs vs placebo and strengthened that antithrombotic drugs do not decrease the risk of stroke (fatal or non-fatal) and increase the risk of major bleeding.