Evaluation of anticoagulant therapy in congestive heart failure.

T HE PURPOSE of this paper is to evaluate the influence of anticoagulant therapy on the incidence of thromboembolic complications and mortality in patients with congestive heart failure. The fact that patients with congestive heart failure are prone to develop thromboembolic complications is well known. Kinsey and White' found pulmonary infarction to be present in 24 of 50 autopsied cases of congestive heart failure. In 1947, Carlotti, Hardy, Linton and White2 noted that of 273 patients with pulmonary infarcts, the admitting diagnosis was congestive heart failure in 104. In 1948, Anderson and Hull reported the use of dicumarol in 61 of 142 patients with congestive heart failure. Thromboembolic complications occurred in 15 per cent of the untreated group and in only 8 per cent of the patients treated with dicumarol. In 1948, Wishart and Chapman14 described the action of dicumarol therapy in 61 patients with congestive heart failure. A comparable control group was not observed. The mortality in this series was 32.8 per cent and the incidence of thromboembolic phenomena during therapy was 6.5 per cent.