Warfarin and antiplatelet therapy study in chronic heart failure (WATCH): Trial design

Massie, B.M.; Armstrong, P.; Cleland, J.G.F.; Collins, John; Ezekowitz, M.; Jafri, Syed M.; Król, W; O'Connor, C.M.; Packer, Milton; Schulman, Kathy L.; Teo, KC; Morgan, Natalie; Ammon, Susan E.

doi:10.1016/s1071-9164(99)91523-3

Cited by 5 publications

(4 citation statements)

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“…The Warfarin/Aspirin Study in Heart failure (WASH) provides no evidence that aspirin is effective in patients with heart failure compared to the placebo group [17]. In the WATCH study, there was no difference in mortality in aspirin, clopidogrel, and warfarin use [18]. Conversely, the meta-analysis of two studies suggests more hospitalizations for CHF in aspirin group [19].…”

Section: Methodsmentioning

confidence: 99%

The aspirin resistance and platelets` receptors expression in chronic heart failure patients with type 2 diabetes mellitus

Kolesnyk¹,

Syvolap²

2014

ZMJ

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Section: Methodsmentioning

confidence: 99%

The aspirin resistance and platelets` receptors expression in chronic heart failure patients with type 2 diabetes mellitus

Kolesnyk¹,

Syvolap²

2014

ZMJ

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“…No reports of bleeding complication was made in the four large-scale non-randomised cohort analyses, as these studies were originally designed as trials examining the value of ACE inhibitors in heart failure management and were not meant to be antithrombotic therapy trials per se. In the WATCH study (56), there were significantly more major bleeding episodes in the warfarin vs. aspirin and clopidogrel (5.6% vs. 3.6% vs. 2.5%, respectively, p ¼ 0.012). In the WASH study (57), there were significantly more major bleeding in the warfarin group than in the aspirin and no antithrombotic treatment groups, with four, one and zero major haemorrhages occurring in the three groups, respectively (p ¼ 0.028).…”

Section: R I S K O F B L E E D I N G W I T H a N T I C O A G U L A T mentioning

confidence: 96%

“…The WASH (57) study showed that mortality was higher but not statistically different in the aspirin group (30%), compared with warfarin (25%) and placebo (21%) groups, whilst the WATCH study (56) showed no difference in mortality between aspirin, clopidogrel and warfarin groups. Both the WASH and WATCH studies also suggested that aspirin use was significantly associated with increased hospitalisations for heart failure.…”

Section: A N T I P L a T E L E T A G E N T S I N C O N G E S T I V E mentioning

confidence: 99%

Antithrombotic therapy for congestive heart failure

Chung¹,

Lip²

2005

International Journal of Clinical Practice

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Patients with congestive heart failure (CHF) are at increased risk of thromboembolic events. However, there is much debate and uncertainty over the use of antithrombotic therapy in these patients. The evidence for oral anticoagulation is limited, although large randomised trial data are forthcoming. Aspirin may be detrimental for heart failure due to a possible interaction with angiotensin-converting enzyme inhibitors, leading to increased hospitalisations from decompensated heart failure. The objective of this review article is to summarise the available evidence regarding the risk of stroke and thromboembolic events in CHF patients, as well as the effectiveness and risks of antithrombotic therapy in these patients.

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“…4 The recently published WATCH (Warfarin versus Antiplatelet Therapy in Chronic Heart Failure) Study is the first large prospective randomized study of warfarin in HF patients in sinus rhythm. 5 The composite primary endpoint (death, myocardial infarction, or nonfatal stroke) did not differ between warfarin and either asprin or clopidogrel; however, nonfatal stroke, a secondary endpoint, was significantly reduced in patients receiving warfarin compared with those receiving either aspirin or clopidogrel (P , .01). The relative risk reduction comparing a combination of stroke and central nervous system hemorrhage between warfarin and aspirin was 35%, almost exactly the same as the previously known risk reduction of 36% (95% confidence interval 5 14%-52%) between warfarin and aspirin in AF.…”

mentioning

confidence: 88%