Reduction in venous thromboembolism, arterial thromboembolism, and deaths seen in high-risk patients in non-ICU, but not ICU, settings<\/p>\n<\/h3>\n
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FRIDAY, Oct. 15, 2021 (HealthDay News) — For adult inpatients with COVID-19 who have elevated D-dimer levels, therapeutic-dose low-molecular-weight heparin (LMWH) reduces major thromboembolism and death compared with standard heparin thromboprophylaxis, according to a study published online Oct. 7 in JAMA Internal Medicine<\/em>.<\/p>\n Alex C. Spyropoulos, M.D., from the Feinstein Institutes for Medical Research in Manhasset, N.Y., and colleagues examined the effects of therapeutic-dose LMWH versus institutional standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized adults with COVID-19 who had evidence of coagulopathy (D-dimer level more than four times the upper limit of normal or sepsis-induced coagulopathy score of 4 or greater). A total of 257 patients were randomly assigned, and 253 were included in the analysis. Overall, 124 and 129 patients were included in the standard-dose heparins and therapeutic-dose LMWH groups, respectively.<\/p>\n The researchers found that the primary efficacy outcome of venous thromboembolism, arterial thromboembolism, or death from any cause was met by 41.9 and 28.7 percent of patients receiving standard-dose heparins and therapeutic-dose LMWH (relative risk, 0.68), including a reduction in thromboembolism (29.0 percent versus 10.9 percent; relative risk, 0.37), respectively. The incidence of major bleeding did not differ significantly and was 1.6 and 4.7 percent with standard-dose and therapeutic-dose heparins, respectively. The primary efficacy outcome was significantly reduced in non-intensive care unit (ICU) patients, but it was not reduced in ICU patients.<\/p>\n “Randomized clinical trials in this patient population to assess any further benefits of therapeutic anticoagulation are ongoing, and novel antithrombotic strategies in critically ill patients with COVID-19 are needed,” the authors write.<\/p>\n Several authors disclosed ties to the pharmaceutical industry.<\/p>\n Abstract\/Full Text<\/a><\/p>\n