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Submitted: 05 January 2017 Modified: 20 January 2017
HERDIN Record #: NCR-PHC-17010511220537

Anticoagulation in patients with dilated cardiomyopathy in sinus rhythm.

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Dilated Cardiomyopathy is a syndrome characterized by cardiac enlargement and impaired systolic function. A variety of clinical predictors of enhanced risk of sudden death such as LV conduction delay, elevated filling pressures, age 75 years, cardiac enlargement, depressed cardiac output, low ejection fraction, increase NYHA functional class, ventricular arrythmias. Body of evidence recommends the use of anticoagulant in dilated cardiomyopathy and heart failure especially patients in atrial fibrillation and prior history of stroke. Anticoagulant theraphy should be continued whenever possible in a patient older than 65 years or one having another risk factor for stroke despite in sinus rhythm. However, little data exist on dilated Cardiomyopathy in sinus rhythm exist to support of the use of such therapy. The objectives of the study were to determine if anticoagulation has a role in patients with cardiomyopathy in sinus rhythm in terms of reducing cardiac events (strokes, deaths) and to determine if anticoagulation has an impact on number of hospitalization, and major and minor bleeding. Among 131 patients with dilated cardiomyopathy of any type from the OPD of PHC, thirty six patients had been identified and fulfilled the inclusion criteria and thus were included in the study. There were 22 patients assigned under  the Non-Coumadin group. sixty eight percent (15) were males and 32% (7) were females, with mean age group of 49 years. There were 14 patients assigned the Coumadin group. Eighty six percent (12) were males and 14% (2) were with the mean age of 52 years. Baseline demographic profiles were statistically analyzed using the ANOVA test. Overall, both group similar demographic profile. Univariate analysis of primary end points using the Fischer exact test showed no significant difference between the two groups. 7.1% of the subjects under the Coamadin group had stroke. Death rate was 4.5% and 7.1% in the Non-Coumadin and Coumadin group respectively (P value=1.00). There were no bleeding complications noted in both groups. Hospitalization was 27.3% and 35.7% in the Non-Coumadin and Coumadin group, respectively (p value = 0.27) and showed no significant difference. This study does not support the use of long term Coumadin therapy in patients with dilated cardiomyopathy in sinus rhythm. Likewise, it showed that Coumadin has no impact on the number of hospitalization, and major and minor bleeding.

Publication Type
Research Project
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LocationLocation CodeAvailable FormatAvailability
Philippine Heart Center Medical Library PHC.R038.04 Fulltext Print Format