Beggs SAS, et al. - In this study, researchers assessed how clinical outcomes in patients with heart failure and reduced ejection fraction (HFrEF) in sinus rhythm are influenced by anticoagulant therapy. For this purpose, they analyzed five eligible trials that compared patients randomized to anticoagulant therapy vs those randomized to antiplatelet therapy, placebo or control. No reduction in all-cause mortality, (re)hospitalization for heart failure or non-fatal myocardial infarction was observed with anticoagulant treatment vs control therapy. The rate of non-fatal stroke was attenuated by anticoagulation, but this was counterbalanced by an increase in the incidence of major hemorrhage. Except for stroke-related morbidity, the presumed significant role of thrombosis or embolism in the morbidity and mortality related to HFrEF was not seen in the evidence generated by this study.