Warfarin Versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial

Warfarin has proven effective in patients with ischemic heart disease, especially in the
reduction of stroke, death and re-infarction following myocardial infarction, and in the
reduction of stroke in atrial fibrillation. Warfarin is the most promising unstudied
intervention in patients with cardiac failure. This randomized, double-blind, multi-center
study will define optimal antithrombotic therapy for patients with cardiac (heart) failure
and patients with low ejection fraction (EF). EF is the proportion of left ventricular
volume emptied during systole. It reliably measures left ventricular systolic function.

With the rapidly increasing numbers of elderly patients with heart failure, this study has
important public health implications. The study will determine which of two commonly used
treatments Warfarin, an anticoagulant, or aspirin, a drug which affects platelet function is
better for preventing death and stroke in patients with low ejection fraction.