Friday, 23 February 2018 18:49

Anticoagulation news items. Week commencing 19th February 2018

Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty

New England Journal of Medicine

RCT (n=3424 on rivaroxaban [RV] 10mg for 5 days initially) found no significant differences in symptomatic venous thromboembolism in group who continued RV or switched to aspirin (81mg daily) for additional 9 days after total knee or for 30 days after total hip arthroplasty.

 

Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging

New England Journal of Medicine

RCT terminated early for efficacy (n=182 in US) found endovascular thrombectomy plus standard medical therapy (SMT) resulted in better functional outcomes (FOs) vs. SMT alone with favorable shift in distribution of FOs on modified Rankin scale at 90 days (OR, 2.77; p<0.001).

 

A Comparison of Reduced-Dose Prasugrel and Standard-Dose Clopidogrel in Elderly Patients with Acute Coronary Syndromes Undergoing Early Percutaneous Revascularization

Circulation

This study in 1443 elderly ACS patients showed no difference in primary endpoint (composite of death, MI, stroke and re-hospitalisation for CV causes/bleeding within 1 year) between reduced-dose prasugrel and standard-dose clopidogrel (17% v 16.6% respectively; HR 1.007, P=0.955).

 

Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people with antiphospholipid syndrome

Cochrane Database of Systematic Reviews

Review based on poor quality evidence from 5RCTs concludes that there is not enough evidence for or against NOACs or for high-intensity VKA.

 

Deep vein thrombosis

British Medical Journal
This clinical update discusses the initial approach to managing patients with suspected DVT, including presentation, diagnosis, complications and treatment (direct oral anticoagulants, low molecular weight heparin and warfarin, role of compression stockings).

 

 

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