Temporal Association Between Episodes of Atrial Fibrillation and Risk of Ischemic Stroke

JAMA Cardiology
Cohort study (n=891) found excess stroke risk was highest within 5 days of an episode of atrial fibrillation (AF) of >5.5 hours in duration and diminished rapidly thereafter, thus supporting trials of time-delimited anticoagulation for infrequent multi-hour episodes of AF.

Revised SPC: Clexane (enoxaparin) pre-filled syringes

electronic Medicines compendium
SPC updated to note licence extension for use as extended treatment of deep vein thrombosis and pulmonary embolism and prevention of its recurrence in patients with active cancer.

Efficacy and Safety of Therapeutic-Dose Heparin vs Standard Prophylactic or Intermediate-Dose Heparins for Thromboprophylaxis in High-risk Hospitalized Patients With COVID-19: The HEP-COVID Randomized Clinical Trial

JAMA Internal Medicine
In RCT (n=253), therapeutic-dose LMWH reduced major thromboembolism & death vs institutional standard heparin thromboprophylaxis (28.7 vs 41.9%;RR 0.68; 95% CI, 0.49-0.96;p= 0.03) among inpatients with very elevated D-dimer levels, with no significant difference in major bleeding.

Unguided de-escalation from ticagrelor to clopidogrel in stabilised patients with acute myocardial infarction undergoing percutaneous coronary intervention (TALOS-AMI): an investigator-initiated, open-label, multicentre, non-inferiority, randomised trial

The Lancet
RCT (n= 2697, South Korea) found unguided de-escalation antiplatelet strategy (switching from ticagrelor+aspirin [TA] to clopidogrel+aspirin) was superior to remaining on TA at preventing net adverse clinical events up to 12 months, mainly by reducing bleeding events.

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