title: Venous thromboembolism prevention in patients with heart failure: an often neglected issue.
abstract: Several epidemiological studies have shown a high prevalence of venous thromboembolism (VTE) complications in patients with acute heart failure; in addition, the level of risk associated with this disease is notable, ranging from 15 to 30%. Three large clinical trials have clearly demonstrated the efficacy and safety of pharmacological prophylaxis in internal medicine patients hospitalized for an acute medical disease; on the contrary, until now there are no studies which have evaluated antithrombotic prophylaxis in a selected population of patients with heart failure only. Moreover, discrepancies existing among recommendations reported in different guidelines may produce uncertainties in the management of VTE prevention in patients with heart failure and may contribute to an underuse of thromboprophylaxis in the daily clinical practice. The aim of this review is to analyze the existing evidence about VTE risk in patients with heart failure as well as the efficacy and safety of antithrombotic prevention, and to underline which are the most important unmet clinical issues for the optimal management of thromboprophylaxis in this particular clinical setting.
authors.affiliation: Dipartimento di Emergenza, Centro Emostasi e Trombosi, Medicina Interna Area Critica, Guglielmo da Saliceto Hospital, Piacenza, Italy. d.imberti@ausl.pc.it
authors.forename: Davide
authors.initials: D
authors.lastname: Imberti
authors.forename: Matteo Giorgi
authors.initials: MG
authors.lastname: Pierfranceschi
authors.forename: Michela
authors.initials: M
authors.lastname: Falciani
authors.forename: Domenico
authors.initials: D
authors.lastname: Prisco
mesh_terms: D064420:Drug-Related Side Effects and Adverse Reactions; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D011292:Premedication; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*
chemical_list: D005343:Fibrinolytic Agents