Antiplatelet versus anticoagulation treatment for people with heart failure in sinus rhythm

There is some evidence from RCTs that OAC with warfarin compared to platelet inhibition with aspirin probably has little to no effect on mortality in people with systolic heart failure in sinus rhythm (moderate-certainty evidence). Treatment with warfarin probably reduces non-fatal cardiovascular events but probably increases the risk of major bleeding complications (moderate-certainty evidence). We saw a similar pattern of results for the warfarin versus clopidogrel comparison (low-certainty evidence). At present, there are no data on the role of OAC versus antiplatelet agents in heart failure with preserved ejection fraction in sinus rhythm. Also, there were no data from RCTs on the utility of non-vitamin K antagonist oral anticoagulants compared to antiplatelet agents in heart failure with sinus rhythm.