Details

Autor(en) / Beteiligte

• Bikdeli, Behnood
• Talasaz, Azita H
• Rashidi, Farid
• Bakhshandeh, Hooman
• Rafiee, Farnaz
• Rezaeifar, Parisa
• Baghizadeh, Elahe
• Matin, Samira
• Jamalkhani, Sepehr
• Tahamtan, Ouria
• Sharif-Kashani, Babak
• Beigmohammadi, Mohammad Taghi
• Farrokhpour, Mohsen
• Sezavar, Seyed Hashem
• Payandemehr, Pooya
• Dabbagh, Ali
• Moghadam, Keivan Gohari
• Khalili, Hossein
• Yadollahzadeh, Mahdi
• Riahi, Taghi
• Abedini, Atefeh
• Lookzadeh, Somayeh
• Rahmani, Hamid
• Zoghi, Elnaz
• Mohammadi, Keyhan
• Sadeghipour, Pardis
• Abri, Homa
• Tabrizi, Sanaz
• Mousavian, Seyed Masoud
• Shahmirzaei, Shaghayegh
• Amin, Ahmad
• Mohebbi, Bahram
• Parhizgar, Seyed Ehsan
• Aliannejad, Rasoul
• Eslami, Vahid
• Kashefizadeh, Alireza
• Dobesh, Paul P
• Kakavand, Hessam
• Hosseini, Seyed Hossein
• Shafaghi, Shadi
• Ghazi, Samrand Fattah
• Najafi, Atabak
• Jimenez, David
• Gupta, Aakriti
• Madhavan, Mahesh V
• Sethi, Sanjum S
• Parikh, Sahil A
• Monreal, Manuel
• Hadavand, Naser
• Hajighasemi, Alireza
• Maleki, Majid
• Sadeghian, Saeed
• Piazza, Gregory
• Kirtane, Ajay J
• Van Tassell, Benjamin W
• Stone, Gregg W
• Lip, Gregory Y H
• Krumholz, Harlan M
• Goldhaber, Samuel Z
• Sadeghipour, Parham

Titel

Intermediate-Dose versus Standard-Dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to the Intensive Care Unit: 90-Day Results from the INSPIRATION Randomized Trial

Ist Teil von

• Thrombosis and haemostasis, 2022-01, Vol.122 (1), p.131

Ort / Verlag

Germany

Erscheinungsjahr

2022

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Thrombotic complications are considered among the main extrapulmonary manifestations of coronavirus disease 2019 (COVID-19). The optimal type and duration of prophylactic antithrombotic therapy in these patients remain unknown.  This article reports the final (90-day) results of the Intermediate versus Standard-dose Prophylactic anticoagulation In cRitically-ill pATIents with COVID-19: An opeN label randomized controlled trial (INSPIRATION) study. Patients with COVID-19 admitted to intensive care were randomized to intermediate-dose versus standard-dose prophylactic anticoagulation for 30 days, irrespective of hospital discharge status. The primary efficacy outcome was a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation (ECMO), or all-cause death. The main safety outcome was major bleeding.  Of 600 randomized patients, 562 entered the modified intention-to-treat analysis (median age [Q1, Q3]: 62 [50, 71] years; 237 [42.2%] women), of whom 336 (59.8%) survived to hospital discharge. The primary outcome occurred in 132 (47.8%) of patients assigned to intermediate dose and 130 (45.4%) patients assigned to standard-dose prophylactic anticoagulation (hazard ratio [HR]: 1.21, 95% confidence interval [CI]: 0.95-1.55,  = 0.11). Findings were similar for other efficacy outcomes, and in the landmark analysis from days 31 to 90 (HR: 1.59, 95% CI: 0.45-5.06). There were 7 (2.5%) major bleeding events in the intermediate-dose group (including 3 fatal events) and 4 (1.4%) major bleeding events in the standard-dose group (none fatal) (HR: 1.82, 95% CI: 0.53-6.24).  Intermediate-dose compared with standard-dose prophylactic anticoagulation did not reduce a composite of death, treatment with ECMO, or venous or arterial thrombosis at 90-day follow-up.