Saturday, 18 April 2015 09:03

Anticoagulation news items. Week commencing 13th April 2015

Optimal duration of dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents: meta-analysis of randomised controlled trials

British Medical Journal

Meta-analysis (10 RCT's; n=32 287) found that short term DAPT (<12 months) after drug eluting stent implementation reduced bleeding with no apparent increase in ischaemic complications vs standard 12 month duration, and could be considered for most patients.

 

Acute Stroke Intervention: A Systematic Review

Journal of the American Medical Association

Systematic review (n = 108 082) found that IV thrombolysis remains the standard of care for patients with moderate to severe neurological deficits who present within 4.5 hours of symptom onset.

 

Prevalence and antithrombotic management of atrial fibrillation in hospitalised patients

Heart

US study (n=812) identified high AF prevalence rates (16.8%) across all wards. Most patients with AF were at high risk for stroke; however anticoagulation therapy was considered inappropriate in 48.7%, indicating the need for guideline optimisation especially in non-cardiac wards.

 

Site-Level Variation in and Practices Associated With Dabigatran Adherence

Journal of the American Medical Association

US study (n= 4863) reported wide variability in medication adherence in patients with nonvalvular AF treated with dabigatran. Pharmacist-led monitoring was associated with higher adherence rates as was pharmacist collaboration with clinicians for nonadherant patients.

 

Medicines Evidence Commentary : Acute coronary syndromes: further evidence on duration of dual antiplatelet therapy after drug-eluting stent implantation

National Institute for Health and Care Excellence

Discussion of a RCT which found that continuing dual antiplatelet therapy beyond 12 months after drug-eluting stent implantation reduced the risk of stent thrombosis, and major cardiovascular and cerebrovascular events at 30 months, compared with switching to aspirin monotherapy.

 

 

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