Friday, 15 September 2017 20:08

Anticoagulation news items. Week commencing 11th September 2017

Bleeding-related hospital admissions and 30-day readmissions in patients with non-valvular atrial fibrillation treated with dabigatran versus warfarin

Journal of Thrombosis and Haemastasis

Dabigatran vs warfarin, was associated with comparable incidence of first hospital admission (incidence rate ratio, 0.92; 95% CI, 0.66-1.28) but higher risk of 30-day readmission with respect to bleeding (adjusted HR, 2.87; 95%CI, 1.10-7.43) in 51,946 Hong Kong patients with AF.

 

The management of antiplatelet therapy in acute coronary syndrome patients with thrombocytopenia: a clinical conundrum

European Heart Journal

In the absence of clinical guidance, this review discusses the evidence and proposes management strategies for antiplatelet therapy in patients with acute coronary syndrome and thrombocytopenia.

 

Rivaroxaban vs Warfarin Sodium in the Ultra-Early Period After Atrial Fibrillation–Related Mild Ischemic Stroke A Randomized Clinical Trial

JAMA Neurology

This RCT (n=195) reports in patients with mild acute ischaemic stroke and AF, new ischaemic lesions or intracranial haemorrhage (noted on MRI imaging) after 4 weeks occurred in 49.5% of patients receiving rivaroxaban v 54.5% receiving warfarin (nonsignificant difference, p=0.49).

 

Long-term mortality and prehospital tirofiban treatment in patients with ST elevation myocardial infarction

Heart
Subgroup analysis of the On-TIME 2 trial (n=984) found that baseline N-terminal pro-B-type natriuretic peptide level predicted long-term mortality. In those with high levels, early prehospital treatment with tirofiban significantly reduced 30-day and 1-year mortality vs placebo.

 

Factor VIII medicines: no clear and consistent evidence of difference in risk of inhibitor development between classes

European Medicines Agency

The European Medicines Agency has concluded there is no clear evidence of a difference in risk of inhibitor development between recombinant factor VIII medicines and those derived from plasma. The risk of inhibitor development should be evaluated individually for each medicine.

 

 

The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:

http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services