[Oral anticoagulant therapy in dilated cardiomyopathy. Warfarin treatment results in subgroups of patients at risk of embolic complications].
BACKGROUND
The aim of the study was to assess the role of oral anticoagulant therapy in patients with dilated cardiomyopathy at risk of embolic complications.


METHODS
We studied retrospectively two hundred thirty-six patients with dilated cardiomyopathy; sixty-eight cases, with intracavitary thrombosis at cross-sectional echocardiography (17 patients), embolic episodes (22), N.Y.H.A. functional class IV (38), chronic atrial fibrillation (23) or with a combination of such conditions, were treated with warfarin. The cumulative period of exposure to embolic events during follow-up was 814 years in the whole population in the absence of anticoagulant treatment and 213 years during treatment.


RESULTS
The rate of new embolic events was 1.6 and 0 for 100 patients-years for the two periods respectively. The difference was not statistically significant. No clinically relevant haemorrhagic complication was seen during treatment.


CONCLUSIONS
Oral anticoagulant therapy may be safely given to subgroups of patients with dilated cardiomyopathy at risk of embolic episodes, following empirical guidelines, provided a careful clinical and laboratory monitoring is carried on, even if no definite conclusion may be obtained about the efficacy of this treatment from a non-randomized study with low rates of new embolic events.
Ciaccheri
M
M
Cardiologia San Luca, Ospedale di Careggi, Firenze.
Castelli
G
G
Nannini
M
M
Santoro
G
G
Troiani
V
V
Dolara
A
A
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016009:Chi-Square Distribution; D004341:Drug Evaluation; D004617:Embolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014859:Warfarin / Q000008:administration & dosage*
D014859:Warfarin
Terapia anticogulante orale nella cardiomopatia dilatativa. Risultati del trattamento con warfarin in sottogruppi di pazienti a rischio di complicanze emboliche.