Wednesday, 23 April 2014 07:43

Anticoagulation news items. Week commencing 14th April 2014

Antiplatelet Therapy for Stable Coronary Artery Disease in Atrial Fibrillation Patients Taking an Oral Anticoagulant: A Nationwide Cohort Study

Circulation
This study in 8700 AF pts with stable CHD found addition of antiplatelet to vitamin K antagonist not linked to reduced risk of recurrent coronary events/thromboembolism, whereas bleeding risk increased significantly: HR aspirin 1.50; 95% CI, 1.23–1.82; clopidogrel 1.84; 1.11–3.06

 

Venous thromboembolic diseases: Evidence Update April 2014

National Institute for Health and Care Excellence 
A summary of selected new evidence published since the NICE guidance on venous thromboembolic diseases (CG 144; 2012) notes that rivaroxaban, apixaban, dabigatran and edoxaban have since been approved and have been or are currently being reviewed by NICE.

 

Bleeding Risk of Patients With Acute Venous Thromboembolism Taking Nonsteroidal Anti-Inflammatory Drugs or Aspirin

JAMA Internal Medicine
This analysis of observational data from the EINSTEIN clinical trials (n=8246) found that use of aspirin or NSAIDs concomitantly with anticoagulation increased the risk of clinically relevant or major bleeding in patients with venous thromboembolism.

 

Anticoagulation in atrial fibrillation

British Medical Journal
This review discusses the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.

 

Fibrinolysis for Patients with Intermediate-Risk Pulmonary Embolism

New England Journal of Medicine
This study (n=1,006) of normotensive patients with intermediate-risk PE found that use of tenecteplase reduced the risk of death or haemodynamic decompensation (2.6% v 5.6% heparin alone) but increased the risk of major bleeding (11.5% v 2.4%) and stroke (2.4% v 0.2%).

 

 

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