Friday, 29 January 2021 18:27

Anticoagulation news items. Week commencing 25th January 2021

Nebulised heparin for patients with or at risk of acute respiratory distress syndrome: a multicentre, randomised, double-blind, placebo-controlled phase 3 trial

The Lancet Respiratory Medicine
Australian RCT (n=252) found no difference in Short Form 36 Health Survey Physical Function Score at day 60 in patients treated with nebulised heparin or placebo (mean 53.6 vs 48.7; difference 4.9; 95% CI −4.8 to 14.5]; p=0.32).

 

Thrombosis, Bleeding, and the Observational Effect of Early Therapeutic Anticoagulation on Survival in Critically Ill Patients With COVID-19

Annals of Internal Medicine
Study (n=3,239) found during median follow-up of 27 days, patients who received early therapeutic anticoagulation had similar risk for death as those who did not (hazard ratio, 1.12 [95% CI, 0.92 to 1.35]) and reports early therapeutic anticoagulation did not affect survival.

 

National Institute for Health Research Alert: Aspirin could reduce the risk of heart attack or stroke in people with pneumonia, research suggests

National Institute for Health Research
Expert commentary is provided for a cohort study which found the risk of cardiovascular events six months after pneumonia diagnosis was one-third lower among aspirin users. Although this is a promising finding, use of aspirin for pneumonia cannot be recommended at present.

 

Valvular atrial fibrillation and a CHA2DS2-VASc score of 1—a statement of the ESC working group on cardiovascular pharmacotherapy and ESC council on stroke

European Heart Journal
Consensus statement provides factors to consider when reviewing the risk/benefit decision for anticoagulation in patients with CHA2DS2-VASc score of 1. A decision tree is provided to support clinicians.

 

Antiplatelet therapy in patients with myocardial infarction without obstructive coronary artery disease

Heart
Patients with MI with non-obstructive coronary arteries, when compared to those with obstructive CAD, had lower overall and CV mortality, repeat MI and major bleeding; intensified clopidogrel offered no additional benefit (2.1% v 0.6% standard dose experienced primary outcome).

 

Atrial fibrillation

New England Journal of Medicine
This article on atrial fibrillation begins with a case vignette, then goes on to discuss diagnosis and evaluation, treatment (rate control; stroke prevention; maintenance of sinus rhythm), and guidelines, and concludes with the authors clinical recommendations.

 

 

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