Friday, 18 February 2022 10:19

Anticoagulation news items. Weeks commencing 14th February 2022

Triple antithrombotic therapy and dual therapy – What is the evidence base?

British Journal of Clinical Pharmacology
Triple antithrombotic therapy refers to concurrent use of oral anticoagulant in combination with dual antiplatelet therapy. Review makes recommendations on duration, noting recommendations in guidelines will remain in flux until there is conclusive evidence about when to step down.

 

Association between oral anticoagulants and COVID-19 related outcomes: a population-based cohort study

British Journal of General Practice
Among 52,832 current oral anticoagulant (OAC) users and 18,271 non-users with low baseline stroke risk (CHA₂DS₂-VASc score 2), those on OACs had a lower risk of testing positive for SARS-CoV-2 (aHR, 0.77, 95%CI, 0.63–0.95) and severe COVID-19 outcomes than non-users.

 

Intravenous thrombolytic treatment and endovascular thrombectomy for ischaemic wake‐up stroke

Cochrane Database of Systematic Reviews
Review of 7 trials (n=980) found both IV thrombolysis and endovascular thrombectomy of large vessel occlusion improved functional outcome without increasing risk of death, but, a possible increased risk of symptomatic intracranial haemorrhage with thrombolysis cannot be ruled out.

 

Treatment Strategies for Proximal Deep Vein Thrombosis: A Network Meta-analysis of Randomised Controlled Trials

European Journal of Vascular and Endovascular Surgery
Review (7 RCTs) found ultrasound assisted catheter directed thrombolysis may improve patency rates vs the other treatment modalities. However, no treatment modality showed superiority in reduction of post-thrombotic syndrome and overall quality of available evidence was poor.

 

 

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