Wireless pulmonary artery haemodynamic monitoring.

摘要

Given the huge effect of heart failure on health care, William Abraham and colleagues'finding of a 39% reduction in hospital admissions for patients with New York Heart Association class III heart failure managed with a wireless implantable haemodynamic monitoring system (Feb 19, p 658) is very important. Abraham and colleagues reportthat, after sensor implantation, patients who were not taking warfarin were placed on aspirin and clopidogrel for 1 month; after this time, only aspirin was continued. Whereas aspirin has been shown to reduce ischaemic events in patients without heart failure, its role in heart failure is controversial, andthere is concern that it could attenuate the haemodynamic and survival benefits of angiotensin-converting-enzyme (ACE) inhibitors. The WASH study also indicated that there were worse outcomes in those who received aspirin than in those who received warfarin, with more aspirin patients admitted to hospital for worsening heart failure. Clopidogrel has not been shown to interact adversely with ACE inhibitors and might even have beneficial effects in terms of preventing clinical events. Clopidogrel is not indicated for primary prevention of ischaemic events.