Nine studies examining the effectiveness of anticoagulation and 5 studies examining the risk of major bleeding associated with anticoagulation.
No clinical trials were located. There is conflicting evidence regarding the effectiveness of anticoagulation: 7 small studies indicated the effectiveness of anticoagulants in preventing arterial embolism, whereas the results from 2 larger studies indicated that patients who had received anticoagulants had the same or higher incidence of stroke, arterial embolism and pulmonary embolism, as those who had not.
The risk of major bleeding in patients who are fully anticoagulated was found to be significant: estimated rates of major bleeding were between 1.5 and 4.4 per 100 patient years for higher doses of anticoagulant. Low-dose anticoagulation appeared to result in fewer bleeding complications.
No studies were found that used multivariate techniques to estimate the independent effect of ventricular dysfunction on the risk of arterial thromboembolism.