COVID and Thrombosis
Therapeutic Anticoagulation with Heparin in Critically Ill and Noncritically Ill Patients with Covid-19
N Engl J Med 2021; 385:790-802 August 26, 2021
Therapeutic doses of heparin, as compared with usual-care venous thromboprophylaxis, increased the probability of surviving to hospital discharge with fewer days of cardiovascular or respiratory support in patients with moderate Covid-19 but not in those with severe Covid-19
ASH Abstract 291. Deep Vein Thrombosis after COVID-19 Vaccinations
Damon E. Houghton et al.
• In this large cohort of COVID-19 vaccinated patients, no increased risk for acute DVT post-vaccination was identified for any of the approved vaccinations in the United States. Additionally, no significant difference was seen in the risk for DVT post-vaccination when comparing each vaccine to each other. These results provide additional reassurance of the safety of approved COVID-19 vaccines.
• Rare thrombotic events (VITT) reported after the Janssen and Moderna vaccinations in the United States
ASH Abstract 1065. Extended Thromboprophylaxis in Patients with COVID-19
Wei Zhao et al.
- Increased incidence of venous and arterial thrombosis in patients hospitalized with COVID-19, role of extended thromboprophylaxis post discharge is unclear
- Estimated <3% incidence of post discharge VTE in unselected patients
ASH Abstract 3214. Inherited Thrombophilias Are Associated with an Increased Risk of COVID-19 Associated Venous Thromboembolism: A Prospective Population-Based Cohort Study
Hannah P. Stevens et al.
- COVID-19 VTE associated with increased COVID-19 mortality (OR 2.731, 95% CI 1.885-3.901) but no association between the studied thrombophilias and COVID-19 mortality
- Some inherited thrombophilias (FVL) increase risk of COVID-19 VTE; may identify a subgroup of COVID-19 patients at higher risk of thrombotic events who require individualized therapy
Factor Xi inhibition
Abelacimab for Prevention of Venous Thrombosis
N Engl J Med 2021; 385:609-17 Aug 12
- Monoclonal Ab that binds and locks FXI in zymogen (inactive precursor) conformation
Milvexian for the Prevention of Venous Thromboembolism
N Engl J Med 2021 Nov 15
- Oral FXI inhibitor
- Phase 2 parallel group trial
- Effective for preventing VTE and associated low risk of bleeding
Refining optimal duration of anticoagulation
ASH Abstract 775. Identification of Patients with Unprovoked Venous Thromboembolism and a Low Risk of Recurrence Estimated by Vienna Prediction Model: A Prospective Cohort Management Study
Sabine Eichinger et al.
- The Vienna prediction model (VPM) identifies patients with unprovoked VTE at low risk of recurrence. Applying the VPM refines risk stratification which could facilitate treatment decisions on the duration of OAC for patients and physicians.
ASH Abstract 776. Risk of Recurrence after Stopping Anticoagulants in Women with Combined Oral Contraceptive-Associated Venous Thromboembolism: A Systematic Review and Meta-Analysis
Jameel Abdulrehman et al.
- The estimated risk of VTE recurrence after a COC-associated VTE is low, and is lower compared to women with unprovoked VTE, however this comparison may be confounded by age