Dr. Cheng is currently employed by Gilead Sciences Inc, Palo Alto, CA, USA.
Antithrombotic therapies in patients with heart failure: hypothesis formulation from a research database†
Article first published online: 1 JUL 2010
Copyright © 2010 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 19, Issue 9, pages 911–920, September 2010
How to Cite
Yuan, Z., Weinstein, R., Zhang, J., Cheng, M., Griffin, G., Zolynas, R., Plotnikov, A. N., Lee, M. S., Oppenheimer, L. and Burton, P. (2010), Antithrombotic therapies in patients with heart failure: hypothesis formulation from a research database. Pharmacoepidem. Drug Safe., 19: 911–920. doi: 10.1002/pds.1987
The data included in the manuscript were partially presented at the 24th International Conference on Pharmacoepidemiology and Drug Safety in August 2008, Copenhagen, Denmark.
- Issue published online: 25 AUG 2010
- Article first published online: 1 JUL 2010
- Manuscript Accepted: 30 APR 2010
- Manuscript Revised: 18 APR 2010
- Manuscript Received: 23 NOV 2009
- heart failure;
- antithrombotic therapy;
Heart failure is a significant public health problem. The present study is intended to explore in a research database whether antithrombotic therapies (ATTs) affect cardiovascular outcomes in patients with incident heart failure (IHF).
Using the United Kingdom Health Improvement Network research database, several multivariable models (including logistic and Cox's regression models, as well as propensity score methods) were used to examine all-cause mortality and clinical outcomes among five treatment groups.
The cohort included 24 554 patients with IHF (50.2% men), with a mean age (standard deviation [SD]) of 76.4 (11.0) years. Nearly three-fourths of patients received at least one form of ATT. Patients receiving ATTs tended to be younger and more likely to be men, and had more cardiovascular comorbidities. During the 18-month follow-up period, the mortality rates were 11.1%, 14.6%, 17.8%, 19.5%, and 32.6% for warfarin combination therapy, warfarin alone, clopidogrel therapy, aspirin (ASA) alone, and no therapy, respectively, yielding odds ratios (95%confidence intervals [CI]) relative to no therapy of 0.28 (0.24, 0.33), 0.38 (0.34, 0.43), 0.46 (0.40, 0.52), and 0.49 (0.45, 0.53) for each therapy group, accordingly. The use of ATTs also appeared to be associated with a reduced risk for ischemic or thrombotic events.
These data contribute to the formulation of the hypothesis that use of ATTs in clinical practice decreases the risk of morbidity and mortality in patients with IHF, although findings require further confirmative studies. Copyright © 2010 John Wiley & Sons, Ltd.