Friday, 24 August 2018 18:19

Anticoagulation news items. Week commencing 20th August 2018

Tranexamic Acid for the Prevention of Blood Loss after Vaginal Delivery

New England Journal of Medicine

In women with vaginal delivery at 35+ weeks' gestation who received prophylactic oxytocin (n=3891), use of tranexamic acid (1g IV) was not associated with a statistically significant reduction in postpartum haemorrhage (8.1% v 9.8% placebo; RR 0.83; 95% CI 0.6-1.01).

 

Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary interventions: a European consensus document

European Heart Journal

This updated joint consensus document discusses the optimal antithrombotic therapy management of this patient group, considering new guidelines published since 2014, and the availability of new drugs, devices, and interventional techniques.

 

Interventions for implementation of thromboprophylaxis in hospitalized patients at risk for venous thromboembolism

Cochrane Database of Systematic Reviews

Review of 13 RCTs (n=35,997) found increased prescription of prophylaxis associated with alerts and multifaceted interventions, and increased prescription of appropriate prophylaxis linked to alerts. Analysis was underpowered to assess effect on mortality and safety outcomes.

 

Uterotonic agents for preventing postpartum haemorrhage: a network meta‐analysis

Cochrane Database of Systematic Reviews

Analysis of 140 RCTs (n=88,947) found ergometrine (EG) + oxytocin (OX) combination, carbetocin, and misoprostol + OX were more effective for preventing postpartum haemorrhage (PPH) ≥500 mL than current standard OX. EG +OX was more effective for preventing PPH ≥1000 mL than OX.

 

Haemostatic therapies for acute spontaneous intracerebral haemorrhage

Cochrane Database of Systematic Reviews

Review of 12 RCTs (n=1732) was unable to draw firm conclusions about efficacy and safety of antifibrinolytic drugs for acute spontaneous intracerebral haemorrhage (ICH), and clotting factors vs. fresh frozen plasma for acute spontaneous ICH associated with anticoagulant drug use.

 

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