Friday, 05 July 2019 19:05

Anticoagulation news items. Week commencing 1st July 2019

Association Between Warfarin Control Metrics and Atrial Fibrillation Outcomes in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation

JAMA Cardiology

In this cohort study of 10,137 patients with atrial fibrillation, historical INR variance was associated with future bleeding events, but not with future stroke risk, suggesting caution when using historical INR to assess likelihood of bleeding or thrombotic events.

 

Antithrombotic doses: clinical observations from published clinical trials

British Journal of Clinical Pharmacology

This review discusses uncertainties around optimal doses of antithrombotic agents e.g. data from RCTs show aspirin is effective at doses below 75 mg daily and direct oral anticoagulants reduce risk of stroke in AF patients at doses 1/4 of those currently recommended.

 

Duration of dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stent: systematic review and network meta-analysis

British Medical Journal

Review found long vs short term (>12 vs <6 months) DAPT resulted in higher rates of major bleeding (OR 1.78, 95% CI 1.27 to 2.49) and non-cardiac death (1.63, 1.03 to 2.59); standard term (12 months) DAPT was associated with higher rates of any bleeding (1.39, 1.01 to 1.92).

 

A Practical Approach to Low-Dose Aspirin for Primary Prevention

Journal of the American Medical Association

This article discusses use of aspirin for primary prevention of atherosclerotic cardiovascular disease in the context of 3 large trials demonstrating bleeding risks comparable with benefits, and proposes a practical approach to initiate, continue, or discontinue aspirin.

 

 

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