A STUDY OF THE BENEFICIAL EFFECTS OF ANTICOAGULANT THERAPY IN CONGESTIVE HEART FAILURE

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Abstract
The results of anticoagulant therapy in 416 of 627 patients with congestive heart failure are presented. Significant reduction in thrombo-embolism was observed in 390 patients maintained at prothrombin levels below 60%. Cardiac arrhythmia, a past history of congestive heart failure or a past history of thromboemboli did not influence the outcome in the treated or the control series. Adequate prophylaxis may be obtained with prothrombin levels up to 45%. The anticoagulants Depo-Heparin, Dicumarol, Tromexan, and Dicumarol, with either Depo-Heparin or Sodium Heparin, were equally beneficial. Some problems relative to the admn. of Tromexan are discussed. Hemorrhagic phenomena were observed in 3% of the control group and in 3% of the treated series. Fear of hemorrhage should not be a deterrent to judicious prophylactic anticoagulant therapy. A new method for determining prothrombin was satisfactorily used to control dosage of the coumarin drugs. The consensus among the 30 residents and the investigators is that the addition of anticoagulant therapy to the conventional treatment of congestive failure is beneficial, but is to be undertaken only under strict clinical observation and an adequate, dependable anticoagulant laboratory.