Friday, 08 June 2018 17:45

Anticoagulation news items. Week commencing 28th May and 4th June 2018

Meta-Analysis of Studies Comparing Dual- Versus Mono-Antiplatelet Therapy Following Transcatheter Aortic Valve Implantation

American Journal of Cardiology

Analysis of 8 studies (n=2439) found dual antiplatelets (vs. mono) linked to increased risk at 30 days of all-cause mortality, major/life-threatening bleeding, and major vascular complications without decrease in ischaemic complications;at 6 months, excess bleeding risk persisted.

 

A clinical prediction model for cancer-associated venous thromboembolism: a development and validation study in two independent prospective cohorts

The Lancet Haematology

Data from CATS cohort (n=1423) were used to select prognostic variables for inclusion in clinical prediction model. Two in final model that were externally validated (tumour-site category/ D-dimer) predicted risk of venous thromboembolism in ambulatory patients with solid cancers.

 

Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery

National Institute for Health Research Signal

Expert commentary is provided for an RCT which found aspirin as effective as rivaroxaban at preventing VTE post hip or knee surgery. While there are implications for savings, the key message is that postoperative prophylaxis is the most important factor for attenuating VTE risk.

 

Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: a population‐based cohort study

British Journal of Clinical Pharmacology

Cohort study (n=413,116) found an increasing adjusted rate difference of GI bleeding for SSRIs vs no SSRIs as kidney function deteriorated (2.0 events per 1000 person-years for no CKD vs 7.9 events per 1000 person-years for CKD stage 4/5, p-trend = 0.001).

 

Antithrombotic Therapy for Peripheral Artery Disease in 2018

Heart

This article reviews cardiovascular risk stratification of patients with peripheral artery disease and current standards of practice for use of antiplatelet and anticoagulant therapies.

 

Revised SPC: Eliquis (apixaban) 2.5 mg film-coated tablets

electronic Medicines compendium

The SPC has been amended to state that 'apixaban can be initiated or continued in NVAF patients who may require cardioversion', and to include detail on dose in relation to cardioversion. Data from the EMANATE study (conducted in patients undergoing cardioversion) has been added.

 

Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial

The Lancet

In this study (n=1,754), the incidence of the primary composite endpoint was lower in those randomised to dabigatran 110mg BD (11% vs 15% with placebo; HR 0.72; 95% CI 0.55-0.93; p=0.0115), with no significant increase in major bleeding (3% v 4%; HR 0.92; 0.55-1.53; p=0.76).

 

 

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