Review ArticlesRole of Antiplatelet Therapy and Anticoagulation in Nonischemic CardiomyopathyCarazo, Matthew MD; Berger, Jeffrey S. MD, MS; Reyentovich, Alex MD; Katz, Stuart D. MD, MS Author Information From the *Department of Medicine, Division of Cardiology, Drexel University College of Medicine, Philadelphia, PA; and †Department of Medicine, Leon H. Charney Division of Cardiology, New York University Langone Medical Center, New York, NY. Disclosure: The authors have no conflicts of interest to report. Correspondence: Stuart D. Katz, MD, MS, Leon H. Charney Division of Cardiology, New York University School of Medicine, 530 First Avenue, Skirball 9R, New York, NY 10016. E-mail: [email protected]. Cardiology in Review: September/October 2016 - Volume 24 - Issue 5 - p 211-217 doi: 10.1097/CRD.0000000000000094 Buy Metrics Abstract Heart failure continues to be a leading cause of morbidity and mortality throughout the United States. The pathophysiology of heart failure involves the activation of complex neurohormonal pathways, many of which mediate not only hypertrophy and fibrosis within ventricular myocardium and interstitium, but also activation of platelets and alteration of vascular endothelium. Platelet activation and vascular endothelial dysfunction may contribute to the observed increased risk of thromboembolic events in patients with chronic heart failure. However, current data from clinical trials do not support the routine use of chronic antiplatelet or oral anticoagulation therapy for ambulatory heart failure patients without other indications (atrial fibrillation and/or coronary artery disease) as the risk of bleeding seems to outweigh the potential benefit related to reduction in thromboembolic events. In this review, we consider the potential clinical utility of targeting specific pathophysiological mechanisms of platelet and vascular endothelial activation to guide clinical decision making in heart failure patients. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.