Items filtered by date: December 2017

Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis

New England Journal of Medicine

RCT (n-692) found that between 6 and 24 months, addition of catheter-directed thrombolysis to anticoagulation did not result in lower risk of post-thrombotic syndrome (47% vs. 48%, respectively) but did result in higher risk of major bleeding. (1.7% vs. 0.3%, p= 0.049).

 

Individualised versus standard duration of elastic compression therapy for prevention of post-thrombotic syndrome (IDEAL DVT): a multicentre, randomised, single-blind, allocation-concealed, non-inferiority trial

The Lancet Haematology

This RCT (n=865) reports post-thrombotic syndrome occurred in 29% of patients receiving individualised duration of therapy and 28% of patients receiving standard duration of therapy (absolute difference was 1.1% (95% CI −5.2 to 7.3), thus meeting the non-inferiority margin.

 

Should This Patient Receive Aspirin?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center

Annals of Internal Medicine

In this discussion, experts review the 2016 US Aspirin Use for the Primary Prevention of Cardiovascular Disease.

 

Thrombo-embolic prevention after transcatheter aortic valve implantation (TAVI)

European Heart Journal

Optimal antithrombotic strategy and duration to mitigate thrombotic and bleeding risks associated with TAVI remains unclear. This review provides an overview of recent insights in this field, and highlights antithrombotic trials focusing on optimising outcomes in this setting.

 

Perioperative management of anticoagulant and antiplatelet therapy

Heart

This narrative review discusses assessment of whether interruption of anticoagulation is required, need for and management of perioperative bridging, management of patients who are receiving direct oral anticoagulants (DOACs) and management of those receiving antiplatelets.

 

 

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

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Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis

British Medical Journal

Review of 23 RCTs (n=94,656) found that apixaban 5mg and dabigatran 150mg twice daily reduced the risk of stroke or systemic embolism vs warfarin. The difference vs warfarin for rivaroxaban or edoxaban was not statistically significant.

 

Dabigatran versus Warfarin for Acute Venous Thromboembolism in Elderly or Impaired Renal Function Patients: Pooled Analysis of RE-COVER and RE-COVER II

Thrombosis and Haemostasis

Pooled analysis (n=5,107) suggests that dabigatran has better efficacy than warfarin in renal impairment, probably because of an increase in the concentration of dabigatran. Incidence of major bleeding increased with increasing renal impairment for both dabigatran and warfarin.

 

FDA grant priority review for avatrombopag for thrombocytopenia in patients with chronic liver disease

Biospace Inc.

The market authorisation application in the US is based on the ADAPT 1 and ADAPT 2 phase 3 trials. Avatrombopag is a second generation orally administered thrombopoetin receptor agonist currently under investigation.

 

Low dose aspirin as adjuvant treatment for venous leg ulceration: pragmatic, randomised, double blind, placebo controlled trial (Aspirin4VLU)

British Medical Journal

RCT (n=251) does not support use of low dose aspirin (150mg daily) as adjuvant treatment for venous leg ulcers (median number of days to healing of largest ulcer: 77 for aspirin vs 69 for placebo; HR 0.85, 95% CI, 0.64 to 1.13, P=0.25).

 

 

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

Published in News