Hypercoagulability in heart failure.

Thromboembolism is an important complication in patients with heart failure. A variety of factors associated with heart failure predispose to thrombosis. These include vascular pathology, increased coagulability, and impaired flow. The focus of this review is to summarize data on platelet function and coagulation indices in heart failure. Several studies have shown that patients with heart failure have increased plasma concentrations of beta-thromboglobulin, a marker of platelet activation. Increased plasma concentrations of fibrinopeptide A and thrombin activation have also been demonstrated. In addition, plasma concentrations of endothelial procoagulants, von Willebrand factor, fibrinolytic products, and D-dimer are also increased during heart failure. If platelet activation and hypercoagulability are a surrogate for clinical events, treatment with antiplatelet or anticoagulant therapy can potentially reduce thromboembolism and mortality in heart failure.