Friday, 22 October 2021 17:45

Anticoagulation news items. Week commencing 18th October 2021

Safety and efficacy of different prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials

European Heart Journal-Cardiovascular Pharmacotherapy
Review (7 RCTs; n=5,154) found escalated-dose prophylactic anticoagulation was associated with lower rates of VTE (2.5% vs. 4.7%; RR 0.55, 95% CI 0.41–0.74) but no benefit on other outcomes vs standard dose; and it increased risk of major bleeding (2.4% vs. 1.4%).

 

Ticagrelor monotherapy in patients at high bleeding risk undergoing percutaneous coronary intervention: TWILIGHT-HBR

European Heart Journal
This pre-specified analysis of the TWILIGHT trial found withdrawal of aspirin after 3 months in those with no events reduced bleeding risk (6.3% vs. 11.4%; HR 0.53, 95% CI 0.35–0.82) without increasing ischaemic events when compared to continued aspirin and ticagrelor.

 

Antithrombotic Therapy in Patients Undergoing Transcatheter Interventions for Structural Heart Disease

Circulation
Review discusses current evidence on the use of antithrombotic therapy in these patients, noting the optimal regimens to adopt in each specific procedure is still unclear, and emphasizing the importance of a tailored approach.

 

Apixaban versus no anticoagulation after anticoagulation-associated intracerebral haemorrhage in patients with atrial fibrillation in the Netherlands (APACHE-AF): a randomised, open-label, phase 2 trial

The Lancet Neurology
RCT (n=101) found over median follow-up of 1.9 years, there was high subsequent annual risk of non-fatal stroke/vascular death, whether allocated to apixaban or to avoid anticoagulation (annual event rate 12·6% vs 11·9%, respectively, HR 1.05; 95% CI 0.48–2.31; p=0.90).

 

 

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