Heart Failure as a Risk Factor for Stroke

Woohyeun Kim, Eung Ju Kim, Woohyeun Kim, Eung Ju Kim

Abstract

Heart failure (HF) is one of the major causes of death worldwide. Despite the high incidence of stroke in patients with HF, there has been a controversy as to whether HF itself is a risk factor for stroke. Recently, there is a great deal of evidence that HF itself increases the risk of stroke. In previous studies, the benefit of warfarin for stroke prevention in patients with HF was offset by the risk of bleeding. In the era of non-vitamin K antagonist oral anticoagulants with low bleeding profiles, we can expect a more effective stroke prevention in patients with HF by selective anticoagulation. The purpose of this review is to describe the relationship between stroke and HF, which could be an unconventional risk factor and a potential intervention target for stroke prevention.

Keywords: CHA2DS2-VASc score; Heart failure; Stroke.

References

    1. Feigin VL, Norrving B, Mensah GA. Global burden of stroke. Circ Res. 2017;120:439–448.
    1. Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: the GBD 2013 study. Neuroepidemiology. 2015;45:161–176.
    1. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1545–1602.
    1. Pullicino PM, McClure LA, Wadley VG, Ahmed A, Howard VJ, Howard G, et al. Blood pressure and stroke in heart failure in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Stroke. 2009;40:3706–3710.
    1. Kannel WB, Wolf PA, Verter J. Manifestations of coronary disease predisposing to stroke. The Framingham study. JAMA. 1983;250:2942–2946.
    1. Witt BJ, Brown RD, Jr, Jacobsen SJ, Weston SA, Ballman KV, Meverden RA, et al. Ischemic stroke after heart failure: a community-based study. Am Heart J. 2006;152:102–109.
    1. Ziaeian B, Fonarow GC. Epidemiology and aetiology of heart failure. Nat Rev Cardiol. 2016;13:368–378.
    1. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–2200.
    1. Writing Group Members, Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, et al. Heart disease and stroke statistics: 2010 update. A report from the American Heart Association. Circulation. 2010;121:e46–e215.
    1. Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, et al. Heart disease and stroke statistics: 2016 update. A report from the American Heart Association. Circulation. 2016;133:e38–e360.
    1. Ponikowski P, Anker SD, AlHabib KF, Cowie MR, Force TL, Hu S, et al. Heart failure: preventing disease and death worldwide. ESC Heart Fail. 2014;1:4–25.
    1. Maggioni AP, Dahlström U, Filippatos G, Chioncel O, Crespo Leiro M, Drozdz J, et al. EURObservational Research Programme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot) Eur J Heart Fail. 2013;15:808–817.
    1. Mamas MA, Sperrin M, Watson MC, Coutts A, Wilde K, Burton C, et al. Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland. Eur J Heart Fail. 2017;19:1095–1104.
    1. Divani AA, Vazquez G, Asadollahi M, Qureshi AI, Pullicino P. Nationwide frequency and association of heart failure on stroke outcomes in the United States. J Card Fail. 2009;15:11–16.
    1. Ois A, Gomis M, Cuadrado-Godia E, Jiménez-Conde J, Rodríguez-Campello A, Bruguera J, et al. Heart failure in acute ischemic stroke. J Neurol. 2008;255:385–389.
    1. Hays AG, Sacco RL, Rundek T, Sciacca RR, Jin Z, Liu R, et al. Left ventricular systolic dysfunction and the risk of ischemic stroke in a multiethnic population. Stroke. 2006;37:1715–1719.
    1. Appelros P, Nydevik I, Viitanen M. Poor outcome after first-ever stroke: predictors for death, dependency, and recurrent stroke within the first year. Stroke. 2003;34:122–126.
    1. Pullicino P, Homma S. Stroke in heart failure: atrial fibrillation revisited? J Stroke Cerebrovasc Dis. 2010;19:1–2.
    1. Haeusler KG, Laufs U, Endres M. Chronic heart failure and ischemic stroke. Stroke. 2011;42:2977–2982.
    1. Adelborg K, Szépligeti S, Sundbøll J, Horváth-Puhó E, Henderson VW, Ording A, et al. Risk of stroke in patients with heart failure: a population-based 30-year cohort study. Stroke. 2017;48:1161–1168.
    1. Sacco RL, Benjamin EJ, Broderick JP, Dyken M, Easton JD, Feinberg WM, et al. American Heart Association Prevention Conference. IV. Prevention and rehabilitation of stroke. Risk factors. Stroke. 1997;28:1507–1517.
    1. Lip GY, Rasmussen LH, Skjøth F, Overvad K, Larsen TB. Stroke and mortality in patients with incident heart failure: the Diet, Cancer and Health (DCH) cohort study. BMJ Open. 2012;2:e000975
    1. Alberts VP, Bos MJ, Koudstaal P, Hofman A, Witteman JC, Stricker B, et al. Heart failure and the risk of stroke: the Rotterdam Study. Eur J Epidemiol. 2010;25:807–812.
    1. Freudenberger RS, Hellkamp AS, Halperin JL, Poole J, Anderson J, Johnson G, et al. Risk of thromboembolism in heart failure: an analysis from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Circulation. 2007;115:2637–2641.
    1. Szummer KE, Solomon SD, Velazquez EJ, Kilaru R, McMurray J, Rouleau JL, et al. Heart failure on admission and the risk of stroke following acute myocardial infarction: the VALIANT registry. Eur Heart J. 2005;26:2114–2119.
    1. Loh E, Sutton MS, Wun CC, Rouleau JL, Flaker GC, Gottlieb SS, et al. Ventricular dysfunction and the risk of stroke after myocardial infarction. N Engl J Med. 1997;336:251–257.
    1. Dries DL, Rosenberg YD, Waclawiw MA, Domanski MJ. Ejection fraction and risk of thromboembolic events in patients with systolic dysfunction and sinus rhythm: evidence for gender differences in the studies of left ventricular dysfunction trials. J Am Coll Cardiol. 1997;29:1074–1080.
    1. Anter E, Jessup M, Callans DJ. Atrial fibrillation and heart failure: treatment considerations for a dual epidemic. Circulation. 2009;119:2516–2525.
    1. Hohendanner F, Heinzel FR, Blaschke F, Pieske BM, Haverkamp W, Boldt HL, et al. Pathophysiological and therapeutic implications in patients with atrial fibrillation and heart failure. Heart Fail Rev. 2018;23:27–36.
    1. Abraham JM, Connolly SJ. Atrial fibrillation in heart failure: stroke risk stratification and anticoagulation. Heart Fail Rev. 2014;19:305–313.
    1. Santhanakrishnan R, Wang N, Larson MG, Magnani JW, Mc-Manus DD, Lubitz SA, et al. Atrial fibrillation begets heart failure and vice versa: temporal associations and differences in preserved versus reduced ejection fraction. Circulation. 2016;133:484–492.
    1. Kang SH, Kim J, Park JJ, Oh IY, Yoon CH, Kim HJ, et al. Risk of stroke in congestive heart failure with and without atrial fibrillation. Int J Cardiol. 2017;248:182–187.
    1. Kotecha D, Chudasama R, Lane DA, Kirchhof P, Lip GY. Atrial fibrillation and heart failure due to reduced versus preserved ejection fraction: a systematic review and meta-analysis of death and adverse outcomes. Int J Cardiol. 2016;203:660–666.
    1. Mogensen UM, Jhund PS, Abraham WT, Desai AS, Dickstein K, Packer M, et al. Type of atrial fibrillation and outcomes in patients with heart failure and reduced ejection fraction. J Am Coll Cardiol. 2017;70:2490–2500.
    1. Lip GY, Piotrponikowski P, Andreotti F, Anker SD, Filippatos G, Homma S, et al. Thromboembolism and antithrombotic therapyfor heart failure in sinus rhythm: an executive summary of a joint consensus document from the ESC Heart Failure Association and the ESC Working Group on Thrombosis. Thromb Haemost. 2012;108:1009–1022.
    1. Abdul-Rahim AH, Perez AC, MacIsaac RL, Jhund PS, Claggett BL, Carson PE, et al. Risk of stroke in chronic heart failure patients with preserved ejection fraction, but without atrial fibrillation: analysis of the CHARM-Preserved and I-Preserve trials. Eur Heart J. 2017;38:742–750.
    1. Abdul-Rahim AH, Perez AC, Fulton RL, Jhund PS, Latini R, Tognoni G, et al. Risk of stroke in chronic heart failure patients without atrial fibrillation: analysis of the Controlled Rosuvastatin in Multinational Trial Heart Failure (CORONA) andthe Gruppo Italiano per lo Studio della Sopravvivenzanell’Insufficienza Cardiaca-Heart Failure (GISSI-HF) trials. Circulation. 2015;131:1486–1494.
    1. Freudenberger RS, Hellkamp AS, Halperin JL, Poole J, Anderson J, Johnson G, et al. Risk of thromboembolism in heart failure. Circulation. 2007;115:2637–2641.
    1. Su MY, Lin LY, Tseng YH, Chang CC, Wu CK, Lin JL, et al. CMR-verified diffuse myocardial fibrosis is associated with diastolic dysfunction in HFpEF. JACC Cardiovasc Imaging. 2014;7:991–997.
    1. Zile MR, Gottdiener JS, Hetzel SJ, McMurray JJ, Komajda M, McKelvie R, et al. Prevalence and significance of alterations in cardiac structure and function in patients with heart failure and a preserved ejection fraction. Circulation. 2011;124:2491–2501.
    1. Borlaug BA, Paulus WJ. Heart failure with preserved ejection fraction: pathophysiology, diagnosis, and treatment. Eur Heart J. 2011;32:670–679.
    1. Ferro JM. Cardioembolic stroke: an update. Lancet Neurol. 2003;2:177–188.
    1. Cusick DA, Bonow RO, Chaudhry FA. Left ventricular apical thrombus and myocardial viability: a dobutamine stress echocardiographic study. Echocardiography. 2000;17(6 Pt 1):547–554.
    1. Merlini PA, Bauer KA, Oltrona L, Ardissino D, Cattaneo M, Belli C, et al. Persistent activation of coagulation mechanism in unstable angina and myocardial infarction. Circulation. 1994;90:61–68.
    1. Bhatnagar SK, Hudak A, Al-Yusuf AR. Left ventricular thrombosis, wall motion abnormalities, and blood viscosity changes after first transmural anterior myocardial infarction. Chest. 1985;88:40–44.
    1. Cicala S, de Simone G, Roman MJ, Best LG, Lee ET, Wang W, et al. Prevalence and prognostic significance of wall-motion abnormalities in adults without clinically recognized cardiovascular disease: the Strong Heart Study. Circulation. 2007;116:143–150.
    1. Choi JY, Cha J, Jung JM, Seo WK, Oh K, Cho KH, et al. Left ventricular wall motion abnormalities are associated with stroke recurrence. Neurology. 2017;88:586–594.
    1. Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med. 1995;333:1301–1307.
    1. Hong KS, Lee JS. Statins in acute ischemic stroke: a systematic review. J Stroke. 2015;17:282–301.
    1. Choi JY, Seo WK, Kang SH, Jung JM, Cho KH, Yu S, et al. Statins improve survival in patients with cardioembolic stroke. Stroke. 2014;45:1849–1852.
    1. Hassell ME, Nijveldt R, Roos YB, Majoie CB, Hamon M, Piek JJ, et al. Silent cerebral infarcts associated with cardiac disease and procedures. Nat Rev Cardiol. 2013;10:696–706.
    1. Kozdag G, Ciftci E, Ural D, Sahin T, Selekler M, Agacdiken A, et al. Silent cerebral infarction in chronic heart failure: ischemicand nonischemic dilated cardiomyopathy. Vasc Health Risk Manag. 2008;4:463–469.
    1. Vogels RL, van der Flier WM, van Harten B, Gouw AA, Schroeder-Tanka JM, et al. Brain magnetic resonance imaging abnormalities in patients with heart failure. Eur J Heart Fail. 2007;9:1003–1009.
    1. Siachos T, Vanbakel A, Feldman DS, Uber W, Simpson KN, Pereira NL. Silent strokes in patients with heart failure. J Card Fail. 2005;11:485–489.
    1. Schmidt R, Fazekas F, Offenbacher H, Dusleag J, Lechner H. Brain magnetic resonance imaging and neuropsychologic evaluation of patients with idiopathic dilated cardiomyopathy. Stroke. 1991;22:195–199.
    1. Kozdag G, Ciftci E, Vural A, Selekler M, Sahin T, Ural D, et al. Silent cerebral infarction in patients with dilated cardiomyopathy: echocardiographic correlates. Int J Cardiol. 2006;107:376–381.
    1. Havakuk O, King KS, Grazette L, Yoon AJ, Fong M, Bregman N, et al. Heart failure-induced brain injury. J Am Coll Cardiol. 2017;69:1609–1616.
    1. Dardiotis E, Giamouzis G, Mastrogiannis D, Vogiatzi C, Skoularigis J, Triposkiadis F, et al. Cognitive impairment in heart failure. Cardiol Res Pract. 2012;2012:595821.
    1. Almeida OP, Garrido GJ, Beer C, Lautenschlager NT, Arnolda L, Flicker L. Cognitive and brain changes associated with ischaemic heart disease and heart failure. Eur Heart J. 2012;33:1769–1776.
    1. Vogels RL, Scheltens P, Schroeder-Tanka JM, Weinstein HC. Cognitive impairment in heart failure: a systematic review of the literature. Eur J Heart Fail. 2007;9:440–449.
    1. Sauvé MJ, Lewis WR, Blankenbiller M, Rickabaugh B, Pressler SJ. Cognitive impairments in chronic heart failure: a case controlled study. J Card Fail. 2009;15:1–10.
    1. Huijts M, van Oostenbrugge RJ, Duits A, Burkard T, Muzzarelli S, Maeder MT, et al. Cognitive impairment in heart failure: results from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF) randomized trial. Eur J Heart Fail. 2013;15:699–707.
    1. Athilingam P, D’Aoust RF, Miller L, Chen L. Cognitive profile in persons with systolic and diastolic heart failure. Congest Heart Fail. 2013;19:44–50.
    1. Zuccalà G, Onder G, Marzetti E, Monaco MR, Cesari M, Cocchi A, et al. Use of angiotensin-converting enzyme inhibitors and variations in cognitive performance among patients with heart failure. Eur Heart J. 2005;26:226–233.
    1. Mohr JP, Albers GW, Amarenco P, Babikian VL, Biller J, Brey RL, et al. Etiology of stroke. Stroke. 1997;28:1501–1506.
    1. Haeusler KG, Endres M, Doehner W. Relevance of heart failure in prevention, treatment and prognosis of ischemic stroke. Neurol Int Open. 2017;1:E61–E64.
    1. Lip GY, Gibbs CR. Does heart failure confer a hypercoagulable state? Virchow’s triad revisited. J Am Coll Cardiol. 1999;33:1424–1426.
    1. Di Tullio MR, Qian M, Thompson JL, Labovitz AJ, Mann DL, Sacco RL, et al. Left ventricular ejection fraction and risk of stroke and cardiac events in heart failure: data from the warfarin versus aspirin in reduced ejection fraction trial. Stroke. 2016;47:2031–2037.
    1. Falk RH, Foster E, Coats MH. Ventricular thrombi and thromboembolism in dilated cardiomyopathy: a prospective follow-up study. Am Heart J. 1992;123:136–142.
    1. Meltzer RS, Visser CA, Fuster V. Intracardiac thrombi and systemic embolization. Ann Intern Med. 1986;104:689–698.
    1. Pullicino PM, Halperin JL, Thompson JL. Stroke in patients with heart failure and reduced left ventricular ejection fraction. Neurology. 2000;54:288–294.
    1. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983–988.
    1. Jug B, Vene N, Salobir BG, Sebestjen M, Sabovic M, Keber I. Procoagulant state in heart failure with preserved left ventricular ejection fraction. Int Heart J. 2009;50:591–600.
    1. de Peuter OR, Kok WE, Torp-Pedersen C, Büller HR, Kamphuisen PW. Systolic heart failure: a prothrombotic state. Semin Thromb Hemost. 2009;35:497–504.
    1. Chong AY, Lip GY. Viewpoint: the prothrombotic state in heart failure: a maladaptive inflammatory response? Eur J Heart Fail. 2007;9:124–128.
    1. Lee KW, Blann AD, Lip GY. Impaired tissue Doppler diastolic function in patients with coronary artery disease: relationship to endothelial damage/dysfunction and platelet activation. Am Heart J. 2005;150:756–766.
    1. Chin BS, Conway DS, Chung NA, Blann AD, Gibbs CR, Lip GY. Interleukin-6, tissue factor and von Willebrand factor in acute decompensated heart failure: relationship to treatment and prognosis. Blood Coagul Fibrinolysis. 2003;14:515–521.
    1. Jafri SM, Mammen EF, Masura J, Goldstein S. Effects of warfarin on markers of hypercoagulability in patients with heart failure. Am Heart J. 1997;134:27–36.
    1. Jafri SM. Hypercoagulability in heart failure. Semin Thromb Hemost. 1997;23:543–545.
    1. Lip GY, Lowe GD, Metcalfe MJ, Rumley A, Dunn FG. Is diastolic dysfunction associated with thrombogenesis? A study of circulating markers of a prothrombotic state in patients with coronary artery disease. Int J Cardiol. 1995;50:31–42.
    1. Lip GY, Lowe GD, Metcalfe MJ, Rumley A, Dunn FG. Effects of warfarin therapy on plasma fibrinogen, von Willebrand factor, and fibrin D-dimer in left ventricular dysfunction secondary to coronary artery disease with and without aneurysms. Am J Cardiol. 1995;76:453–458.
    1. Sbarouni E, Bradshaw A, Andreotti F, Tuddenham E, Oakley CM, Cleland JG. Relationship between hemostatic abnormalities and neuroendocrine activity in heart failure. Am Heart J. 1994;127:607–612.
    1. Jafri SM, Ozawa T, Mammen E, Levine TB, Johnson C, Goldstein S. Platelet function, thrombin and fibrinolytic activity in patients with heart failure. Eur Heart J. 1993;14:205–212.
    1. Keber I, Keber D, Stegnar M, Vene N. Tissue plasminogen activator release in chronic venous hypertension due to heart failure. Thromb Haemost. 1992;68:321–324.
    1. Gibbs CR, Blann AD, Watson RD, Lip GY. Abnormalities of hemorheological, endothelial, and platelet function in patients with chronic heart failure in sinus rhythm: effects of angiotensin-converting enzyme inhibitor and beta-blocker therapy. Circulation. 2001;103:1746–1751.
    1. Niebauer J, Volk HD, Kemp M, Dominguez M, Schumann RR, Rauchhaus M, et al. Endotoxin and immune activation in chronic heart failure: a prospective cohort study. Lancet. 1999;353:1838–1842.
    1. Kubo SH, Rector TS, Bank AJ, Williams RE, Heifetz SM. Endothelium-dependent vasodilation is attenuated in patients with heart failure. Circulation. 1991;84:1589–1596.
    1. Georgiadis D, Sievert M, Cencetti S, Uhlmann F, Krivokuca M, Zierz S, et al. Cerebrovascular reactivity is impaired in patients with cardiac failure. Eur Heart J. 2000;21:407–413.
    1. Rajagopalan B, Raine AE, Cooper R, Ledingham JG. Changes in cerebral blood flow in patients with severe congestive cardiac failure before and after captopril treatment. Am J Med. 1984;76(5B):86–90.
    1. Lorenzi-Filho G, Azevedo ER, Parker JD, Bradley TD. Relationship of carbon dioxide tension in arterial blood to pulmonary wedge pressure in heart failure. Eur Respir J. 2002;19:37–40.
    1. Derdeyn CP, Videen TO, Yundt KD, Fritsch SM, Carpenter DA, Grubb RL, et al. Variability of cerebral blood volume and oxygen extraction: stages of cerebral haemodynamic impairment revisited. Brain. 2002;125(Pt 3):595–607.
    1. Weber T, Wassertheurer S, O’Rourke MF, Haiden A, Zweiker R, Rammer M, et al. Pulsatile hemodynamics in patients with exertional dyspnea: potentially of value in the diagnostic evaluation of suspected heart failure with preserved ejection fraction. J Am Coll Cardiol. 2013;61:1874–1883.
    1. Vemmos K, Ntaios G, Savvari P, Vemmou AM, Koroboki E, Manios E, et al. Stroke aetiology and predictors of outcome in patients with heart failure and acute stroke: a 10-year follow-up study. Eur J Heart Fail. 2012;14:211–218.
    1. He J, Ogden LG, Bazzano LA, Vupputuri S, Loria C, Whelton PK. Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch Intern Med. 2001;161:996–1002.
    1. Massie BM, Shah NB. Evolving trends in the epidemiologic factors of heart failure: rationale for preventive strategies and comprehensive disease management. Am Heart J. 1997;133:703–712.
    1. Kannel WB, Ho K, Thom T. Changing epidemiological features of cardiac failure. Br Heart J. 1994;72(2 Suppl):S3–S9.
    1. Lee SE, Cho HJ, Lee HY, Yang HM, Choi JO, Jeon ES, et al. A multicentre cohort study of acute heart failure syndromes in Korea: rationale, design, and interim observations of the Korean Acute Heart Failure (KorAHF) registry. Eur J Heart Fail. 2014;16:700–708.
    1. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37:2893–2962.
    1. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC, Jr, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64:e1–e76.
    1. Cleland JG, Findlay I, Jafri S, Sutton G, Falk R, Bulpitt C, et al. The Warfarin/Aspirin Study in Heart failure (WASH): a randomized trial comparing antithrombotic strategies for patients with heart failure. Am Heart J. 2004;148:157–164.
    1. Cokkinos DV, Haralabopoulos GC, Kostis JB, Toutouzas PK, HELAS investigators Efficacy of antithrombotic therapy in chronic heart failure: the HELAS study. Eur J Heart Fail. 2006;8:428–432.
    1. Massie BM, Collins JF, Ammon SE, Armstrong PW, Cleland JG, Ezekowitz M, et al. Randomized trial of warfarin, aspirin, and clopidogrel in patients with chronic heart failure: the Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) trial. Circulation. 2009;119:1616–1624.
    1. Homma S, Thompson JL, Pullicino PM, Levin B, Freudenberger RS, Teerlink JR, et al. Warfarin and aspirin in patients with heart failure and sinus rhythm. N Engl J Med. 2012;366:1859–1869.
    1. Hopper I, Skiba M, Krum H. Updated meta-analysis on antithrombotic therapy in patients with heart failure and sinus rhythm. Eur J Heart Fail. 2013;15:69–78.
    1. Kondo T, Yamada T, Morita T, Furukawa Y, Tamaki S, Iwasaki Y, et al. The CHADS2 score predicts ischemic stroke in chronic heart failure patients without atrial fibrillation: comparison to other stroke risk scores. Heart Vessels. 2017;32:193–200.
    1. Melgaard L, Gorst-Rasmussen A, Lane DA, Rasmussen LH, Larsen TB, Lip GY. Assessment of the CHA2DS2-VASc score in predicting ischemic stroke, thromboembolism, and death in patients with heart failure with and without atrial fibrillation. JAMA. 2015;314:1030–1038.
    1. Melgaard L, Gorst-Rasmussen A, Lip GY, Rasmussen LH, Larsen TB. Female sex is associated with a lower risk of stroke in patients with heart failure. Am Heart J. 2015;169:396–403.
    1. Batul SA, Gopinathannair R. Atrial fibrillation in heart failure: a therapeutic challenge of our times. Korean Circ J. 2017;47:644–662.
    1. Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–2104.
    1. Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–891.
    1. Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–992.
    1. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–1151.
    1. Ferreira J, Ezekowitz MD, Connolly SJ, Brueckmann M, Fraessdorf M, Reilly PA, et al. Dabigatran compared with warfarin in patients with atrial fibrillation and symptomatic heart failure: a subgroup analysis of the RE-LY trial. Eur J Heart Fail. 2013;15:1053–1061.
    1. van Diepen S, Hellkamp AS, Patel MR, Becker RC, Breithardt G, Hacke W, et al. Efficacy and safety of rivaroxaban in patients with heart failure and nonvalvular atrial fibrillation: insights from ROCKET AF. Circ Heart Fail. 2013;6:740–747.
    1. Magnani G, Giugliano RP, Ruff CT, Murphy SA, Nordio F, Metra M, et al. Efficacy and safety of edoxaban compared with warfarin in patients with atrial fibrillation and heart failure: insights from ENGAGE AF-TIMI 48. Eur J Heart Fail. 2016;18:1153–1161.
    1. McMurray JJ, Ezekowitz JA, Lewis BS, Gersh BJ, van Diepen S, Amerena J, et al. Left ventricular systolic dysfunction, heart failure, and the risk of stroke and systemic embolism in patients with atrial fibrillation: insights from the ARISTOTLE trial. Circ Heart Fail. 2013;6:451–460.
    1. Isnard R, Bauer F, Cohen-Solal A, Damy T, Donal E, Galinier M, et al. Non-vitamin K antagonist oral anticoagulants and heart failure. Arch Cardiovasc Dis. 2016;109:641–650.
    1. Xiong Q, Lau YC, Senoo K, Lane DA, Hong K, Lip GY. Non-vitamin K antagonist oral anticoagulants (NOACs) in patients with concomitant atrial fibrillation and heart failure: a systemic review and meta-analysis of randomized trials. Eur J Heart Fail. 2015;17:1192–1200.
    1. Yeh CH, Hogg K, Weitz JI. Overview of the new oral anticoagulants: opportunities and challenges. Arterioscler Thromb Vasc Biol. 2015;35:1056–1065.
    1. Mega JL, Braunwald E, Wiviott SD, Bassand JP, Bhatt DL, Bode C, et al. Rivaroxaban in patients with a recent acute coronary syndrome. N Engl J Med. 2012;366:9–19.
    1. Zannad F, Greenberg B, Cleland JG, Gheorghiade M, van Veldhuisen DJ, Mehra MR, et al. Rationale and design of a randomized, double-blind, event-driven, multicentre study comparing the efficacy and safety of oral rivaroxaban with placebo for reducing the risk of death, myocardial infarction or stroke in subjects with heart failure and significant coronary artery disease following an exacerbation of heart failure: the COMMANDER HF trial. Eur J Heart Fail. 2015;17:735–742.

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