Friday, 12 November 2021 09:52

Anticoagulation news items. Week commencing 8th November 2021

Tranexamic acid in gastrointestinal bleeding: A systematic review and meta-analysis

Critical Care Medicine
Systematic review (12 RCT's) found extended-use high-dose IV tranexamic acid did not improve mortality or bleeding risk & increases adverse events (DVT, PE & seizures). Low-dose/enteral tranexamic acid reduced risk of rebleeding and need for surgery.

 

Comparison of clinical outcomes using activated partial thromboplastin time versus antifactor-Xa for monitoring therapeutic unfractionated heparin: A systematic review and meta-analysis

Thrombosis Research
This systematic review (n=6677, 10 studies) found pooled data suggests no difference in bleeding or thrombosis rates when comparing activated partial thromboplastin time and antifactor Xa heparin assay for monitoring of therapeutic unfractionated heparin.

 

A Randomized Trial of Intravenous Alteplase before Endovascular Treatment for Stroke

New England Journal of Medicine
RCT (n=539) found endovascular treatment (EVT) was neither superior nor noninferior to IV alteplase followed by EVT with regard to disability outcome at 90 days after stroke (OR 0.84; 95% CI, 0.62-1.15) & incidence of symptomatic intracerebral haemorrhage was similar (5.9 v 5.3%).

 

Vaccine-induced immune thrombotic thrombocytopenia (VITT)

The Lancet Haematology
Viewpoint discusses epidemiology, pathophysiology, and optimal diagnostic and therapeutic management of VITT. Presentation of possible VITT should raise prompt testing for anti-PF4 antibodies and initiation of treatment with IV immunoglobulin and non-heparin anticoagulation.

 

 

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