Sunday, 27 April 2014 13:43

Anticoagulation news items. Week commencing 21st April 2014

Periprocedural Stroke and Bleeding Complications in Patients undergoing Catheter Ablation of Atrial Fibrillation with Different Anticoagulation Management: Results from the "COMPARE" Randomized Trial

Circulation
This open-label study (n=1584) found that performing catheter ablation for AF without stopping warfarin reduced the incidence of thromboembolic events 48 hours post-ablation, when compared to stopping warfarin and bridging with LMWH (0.25% v 4.9%, respectively; p<0.001).

 

Door-to-Needle Times for Tissue Plasminogen Activator Administration and Clinical Outcomes in Acute Ischemic Stroke Before and After a Quality Improvement Initiative

Journal of the American Medical Association
This US study found implementation of a national quality improvement initiative for acute ischaemic stroke improved door-to-needle times for tPA administration; this was associated with lower in-hospital mortality (9.93% v 8.25%) and ICH (5.68% v 4.68%; both P<0.001).

 

Effect of the Use of Ambulance-Based Thrombolysis on Time to Thrombolysis in Acute Ischemic Stroke: A Randomized Clinical Trial

Journal of the American Medical Association
Use of a specialised ambulance in which patients could have thrombolysis administered before transport to hospital where appropriate decreased time to treatment by 25 min, with no increase in adverse events. Further studies are needed to assess effects on clinical outcomes.

 

Thrombocytosis is associated with increased short and long term mortality after exacerbation of chronic obstructive pulmonary disease: a role for antiplatelet therapy?

Thorax
Thrombocytosis was associated with 1-year mortality (OR 1.53 (95% CI 1.03 to 2.29, p=0.030) but treatment with an antiplatelet drug (aspirin or clopidogrel) reduced this mortality rate (OR 0.63 (95% CI 0.47 to 0.85, p=0.003) in 1343 patients with acute exacerbations of COPD.

 

Expert position paper on the management of antiplatelet therapy in patients undergoing coronary artery bypass graft surgery

European Heart Journal
This review specifically addresses; risk stratification for bleeding and recurrent ischaemic events, temporary interruption of antiplatelet therapy, bridging strategies, use of platelet function monitoring, and blood sparing management strategies.

 

 

 

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