Friday, 12 October 2018 17:22

Anticoagulation news items. Week commencing 8th October 2018

Individually shortened duration versus standard duration of elastic compression therapy for prevention of post-thrombotic syndrome: a cost-effectiveness analysis

The Lancet Haematology

Dutch RCT (n=865) found that, using the UK tariff for EQ-5D for ascertaining Quality Adjusted Life Years, an individualised strategy was more effective in clinical outcomes and less costly than standard 2 years of elastic stocking compression therapy.

 

P2Y12-ADP Receptor Blockade in Chronic Kidney Disease Patients With Acute Coronary Syndromes: Review of the Current Evidence

Circulation

This review summarises the mechanisms involved in the high ischaemic and bleeding risk of patients with chronic kidney disease CKD and the risk–benefit ratio of potent antiplatelet drugs during acute coronary syndrome.

 

Rivaroxaban (Xarelto▼) after transcatheter aortic valve replacement:increase in all-cause mortality, thromboembolic and bleeding events in a clinical trial

Medicines and Healthcare products Regulatory Agency

MHRA advises that rivaroxaban treatment in patients who undergo transcatheter aortic valve replacement should be stopped and switched to standard of care. It notes rivaroxaban is not licensed for thromboprophylaxis in patients with prosthetic heart valves, and should not be used.

 

Atrial fibrillation, antithrombotic treatment, and cognitive aging: A population-based study

Neurology

Swedish cohort study (n=2685) found AF linked to faster global cognitive decline and an increased risk of all cause dementia in older people (HR 1.40, 95% CI, 1.11–1.77). Use of anticoagulant drugs (but not antiplatelets) may reduce dementia risk in this group (0.40; 0.18–0.92).

 

Surgery versus thrombolysis for initial management of acute limb ischaemia

Cochrane Database of Systematic Reviews

This updated review (5 RCTs; nil new) concludes there is currently no evidence in favour of either initial thrombolysis or initial surgery as the preferred option in terms of limb salvage, amputation, or death; thrombolysis may be associated with higher risk of complications.

 

 

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