Friday, 07 May 2021 18:36

Anticoagulation news items. Weeks commencing 26th April & 3rd May 2021

Prior use of therapeutic anticoagulation does not protect against COVID‐19 related clinical outcomes in hospitalized patients: a propensity score‐matched cohort study

British Journal of Clinical Pharmacology
Retrospective Dutch study (n=1154) found no associations between prior therapeutic anticoagulation use (16% of population) and mortality (RR 1.02; 95% CI; 0.80‐1.30) or length of hospital stay (7.0 vs 7.0 days, p=0.69), except lower risk of pulmonary embolism (0.19; 0.05‐0.80).

 

Atrial fibrillation: diagnosis and management- Updated guidance (NG196)

National Institute for Health and Care Excellence
Updates include use of tools to calculate risk of bleeding when considering use of anticoagulants, role of newer anti-clotting drugs, and use of treatments that aim to destroy or isolate the abnormal sources of electrical impulses in the heart that may be driving AF (ablation).

 

Is there a circannual variation in the anticoagulation control of warfarin?

European Journal of Hospital Pharmacy
This retrospective study (n=204) found no significant intra-individual differences in mean time in therapeutic range. Patients with poor anticoagulation control, high INR variability and high warfarin sensitivity index was not significantly different between the seasons.

 

Genotype‐guided antiplatelet treatment versus conventional therapy: A systematic review and meta‐analysis

British Journal of Clinical Pharmacology
Review of 16 studies (n=10,561, 8 studies were RCTs) found lower rates of major adverse cardiovascular events (RR 0.56, 95%CI 0.44‐0.73), stent thrombosis (0.40, 0.24‐0.67) and myocardial infarction (0.45, 0.35‐0.58) with genotype‐guided vs conventional treatment.

 

Tranexamic Acid for the Prevention of Blood Loss after Cesarean Delivery

New England Journal of Medicine
RCT (n=4551) found tranexamic acid resulted in a significantly lower incidence (LI) of calculated estimated blood loss >1000ml or red-cell transfusion by day 2 vs. placebo (26.7% vs. 31.6%, risk ratio, 0.84; 95% CI, 0.75-0.94; p=0.003), but not LI of haemorrhage-related outcomes.

 

Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: population based cohort study

British Medical Journal
Study (n=281,264) notes increased rates of VTE events (standardised morbidity ratio 1.97; 95% CI, 1.50 to 2.54 and 11 [5.6 to 17.0] excess events per 100 000 vaccinations) including cerebral venous thrombosis, but the absolute risks were small.

 

 

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