{"id":"53f5d5bfbfef","type":"article","url":"https://hartvaat.nl/2019/09/01/antistolling-bij-hf-met-sinusritme-systematische-review-en-meta-analyse/","title":"Antistolling bij HF met sinusritme: systematische review en meta-analyse","title_en":"Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"Heart (British Cardiac Society)","doi":"10.1136/heartjnl-2018-314381","source_url":"https://doi.org/10.1136/heartjnl-2018-314381","authors":["Simon A S Beggs","Rasmus Rørth","Roy S Gardner","John J V McMurray"],"significance":7,"published":"2019-09-01","source_date":"2019-09-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/digoxine-bij-hartfalen/"],"congress":"","summary_en":"This meta-analysis found that anticoagulation therapy does not significantly reduce mortality or cardiovascular events in heart failure patients in sinus rhythm, consistent with the COMMANDER HF result and arguing against routine anticoagulation without AF.","created":"2026-07-03T10:28:06Z","updated":"2026-07-03T13:27:18Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse naar het effect van antistollingstherapie bij hartfalenpatiënten in sinusritme (zonder AF). Syntheseert het COMMANDER HF- en WARCEF-bewijs.","abstract_original":"OBJECTIVE: Heart failure is a prothrombotic state, and it has been hypothesised that thrombosis and embolism cause non-fatal and fatal events in heart failure and reduced ejection fraction (HFrEF). We sought to determine the effect of anticoagulant therapy on clinical outcomes in patients with HFrEF who are in sinus rhythm. METHODS: We conducted an updated systematic review and meta-analysis to examine the effect of anticoagulation therapy in patients with HFrEF in sinus rhythm. Our analysis compared patients randomised to anticoagulant therapy with those randomised to antiplatelet therapy, placebo or control, and examined the endpoints of all-cause mortality, (re)hospitalisation for worsening heart failure, non-fatal myocardial infarction, non-fatal stroke of any aetiology and major haemorrhage. RESULTS: Five trials were identified that met the prespecified search criteria. Compared with control therapy, anticoagulant treatment did not reduce all-cause mortality (risk ratio [RR] 0.99, 95% CI 0.90 to 1.08), (re)hospitalisation for heart failure (RR 0.97, 95% CI 0.82 to 1.13) or non-fatal myocardial infarction (RR 0.92, 95% CI 0.75 to 1.13). Anticoagulation did reduce the rate of non-fatal stroke (RR 0.63, 95% CI 0.49 to 0.81, p=0.001), but this was offset by an increase in the incidence of major haemorrhage (RR 1.88, 95% CI 1.49 to 2.38, p=0.001). CONCLUSIONS: Our meta-analysis provides evidence to oppose the hypothesis that thrombosis or embolism plays an important role in the morbidity and mortality associated with HFrEF, with the exception of stroke-related morbidity."}