Hematology (all articles)
[Preprint] Practice Changing RCT: Therapeutic-dose anticoagulation with heparin (LMWH or unfractionated heparin) improves outcomes in non-critically ill patients with Covid-19 – the superiority of therapeutic-dose anticoagulation was seen in both high and low D-dimer groups.
18 May, 2021 | 08:04h | UTCTherapeutic Anticoagulation in Non-Critically Ill Patients with Covid-19 – medRxiv
Commentary on Twitter
Final results of the mpRCT now on preprint server. In non-critically ill patients with COVID-19 (n=2219), therapeutic-dose anticoagulation with heparins increases survival to hospital discharge with reduced use of organ support. https://t.co/TkhGs5qow5
— Ryan Zarychanski (@RZarychanski) May 17, 2021
#ACC21 – [Not published yet] RCT: Among hospitalized patients with Covid-19 and elevated D-Dimer, therapeutic anticoagulation with Rivaroxaban 20 mg was not associated with improved outcomes and resulted in increased major bleeding.
18 May, 2021 | 08:01h | UTCAntiCoagulaTIon cOroNavirus – ACTION – American College of Cardiology
Commentary: ACTION: Full-Dose Rivaroxaban Doesn’t Help in Hospitalized COVID-19 – TCTMD
#ACC21 – RCT: Clopidogrel better than aspirin for chronic maintenance monotherapy after percutaneous coronary intervention.
18 May, 2021 | 07:34h | UTCAspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial – The Lancet (free registration required)
Commentaries: Harmonizing Optimal Strategy for Treatment of coronary artery diseases-EXtended Antiplatelet Monotherapy – HOST-EXAM – American College of Cardiology AND Clopidogrel, Not Aspirin, for Post-DAPT Monotherapy After PCI: HOST-EXAM – TCTMD
Commentary on Twitter
The sensational news of the day comes from South Korea. In a timely comparison of single antiplatelet monotherapies, clopidogrel beats aspirin during the chronic maintenance period after PCI, with curves diverging at 9 months. #ACC21https://t.co/Pp49LxcNWf pic.twitter.com/J9Un4QHzgL
— Davide Capodanno (@DFCapodanno) May 16, 2021
RECOVERY Trial: No benefit from convalescent plasma in patients admitted to hospital with COVID-19.
17 May, 2021 | 08:56h | UTCInvited commentary: Convalescent plasma in patients hospitalised with COVID-19
Commentaries on Twitter
Convalescent plasma:
Yet another example of
Don’t guess, don’t gamble
Randomize… and learn
I’ve heard it said that it was deemed “too difficult” to do a randomised controlled trial. Really? If that’s the case, we must (and can) fix that problem. Pts deserve better. https://t.co/zxIiK5U63v
— Martin Landray (@MartinLandray) May 15, 2021
NEW #COVID19 research—In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Read https://t.co/7Sbe8V9THp. #RECOVERY #RECOVERYtrial pic.twitter.com/D0OLZKxZc4
— The Lancet (@TheLancet) May 16, 2021
‘It’s not over yet’: Uncertain protection from Covid vaccines leaves cancer patients in limbo.
17 May, 2021 | 08:45h | UTC‘It’s not over yet’: Uncertain protection from Covid vaccines leaves cancer patients in limbo – STAT
#ACC21 – RCT: No significant differences in cardiovascular events or major bleeding between patients receiving 81 mg vs. 325 mg of aspirin daily.
17 May, 2021 | 08:31h | UTCComparative Effectiveness of Aspirin Dosing in Cardiovascular Disease – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries: High- and Low-Dose Aspirin Equivalent in ASCVD: ADAPTABLE – TCTMD AND Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-Term Effectiveness – ADAPTABLE – American College of Cardiology
Video: Aspirin Dosing: A Patient-centric Trial Assessing Benefits And Long-term Effectiveness Trial
2 recent meta-analysis highlight the benefits of short term (30 days) dual antiplatelet therapy with aspirin + clopidogrel in patients within 24 hours of high-risk transient ischemic attack or mild-moderate ischemic stroke.
17 May, 2021 | 08:16h | UTCMeta-analysis 1: Dual Antiplatelet Therapy Versus Aspirin in Patients With Stroke or Transient Ischemic Attack: Meta-Analysis of Randomized Controlled Trials – Stroke
Meta-analysis 2: Efficacy and Safety of Using Dual Versus Monotherapy Antiplatelet Agents in Secondary Stroke Prevention: Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials – Circulation (link to abstract – $ for full-text)
Commentary: Dual vs. Monotherapy Antiplatelet Agents in Secondary Stroke Prevention – American College of Cardiology
Related Guideline: Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke – The BMJ
[Preprint] Meta-analysis of risk of vaccine-induced immune thrombotic thrombocytopenia following ChAdOx1-S recombinant vaccine – Overall risk is 1 in 139,000; for age 65 and over, about 1 in 1,000,000; for age under 55, between 1 in 20,000 to 60,000.
12 May, 2021 | 08:45h | UTC
Systematic review: Use of compression stockings by airline passengers can reduce symptomless deep vein thrombosis and leg edema
11 May, 2021 | 09:04h | UTCCompression stockings for preventing deep vein thrombosis in airline passengers – Cochrane Library
Cohort study: Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S. 11 excess venous thromboembolic events per 100 000 vaccinations; 2.5 excess cerebral venous thrombosis per 100 000 vaccinations.
7 May, 2021 | 08:33h | UTCEditorial: Thromboembolism and the Oxford-AstraZeneca vaccine – The BMJ
Commentaries: Thrombosis and bleeding after the Oxford-AstraZeneca covid-19 vaccination – The BMJ Opinion AND Putting risks into context: covid-19 vaccines and blood clots – The BMJ Opinion AND Expert reaction to study from Denmark and Norway looking at rare blood clots after the Oxford-AstraZeneca vaccine – Science Media Centre
Commentary on Twitter
NEW research sheds more light on rate of rare blood clots after Oxford-AstraZeneca vaccine
Rate of adverse events low; benefits of the vaccine still outweigh risks in most situations, say researchershttps://t.co/LslgvzWlWi @Pottegard
— The BMJ (@bmj_latest) May 6, 2021
What’s the future of vaccines linked to rare clotting disorders? Science breaks down the latest
5 May, 2021 | 08:37h | UTC
Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation
4 May, 2021 | 08:38h | UTCCommentary: EHRA Updates Its Popular ‘Practical’ NOAC Guide – TCTMD
Case series of 12 patients with cerebral venous sinus thrombosis with thrombocytopenia after Ad26.COV2.S vaccination – all women younger than 60 years, with symptoms from 6 to 15 days after vaccination
3 May, 2021 | 05:43h | UTCSee also: Safety Monitoring of the Janssen (Johnson & Johnson) COVID-19 Vaccine — United States, March–April 2021 – Centers for Disease Control and Prevention AND Updated Recommendations from the Advisory Committee on Immunization Practices for Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine After Reports of Thrombosis with Thrombocytopenia Syndrome Among Vaccine Recipients — United States, April 2021 – Centers for Disease Control and Prevention
Study on five million Swedes finds links between blood groups and disease risks
3 May, 2021 | 05:09h | UTCNews Release: Study on five million Swedes finds links between blood groups and disease risks – Karolinska Institutet
Original Study: An agnostic study of associations between ABO and RhD blood group and phenome-wide disease risk – eLife
RCT: Tranexamic acid for the prevention of blood loss after cesarean delivery – even though TA resulted in a significantly lower incidence of estimated blood loss, the clinical relevance of the findings was small
30 Apr, 2021 | 08:38h | UTC
Commentaries on Twitter
Another typically "positive" trial for TXA.
"the mean between-group difference was approximately 100 ml …. the clinical relevance of this narrow difference is questionable"
– No difference in RBC transfusions.
– 0.4% vs 0.1% VTE at 3 mos.— Ryan Radecki, MD MS (@emlitofnote) April 28, 2021
NEJM-Prevention of Blood Loss after Cesarean Delivery | tranexamic acid ➡️ significantly lower incidence of EBL greater than 1000 ml or RBC transfusion by day 2 than placebo, but did not result in a ⬇️ incidence of hemorrhage-related secondary outcomes https://t.co/ydF5HgHM0N
— Skeptical Scalpel (@Skepticscalpel) April 28, 2021
AHA/ASA Guidance: Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Thrombotic Thrombocytopenia – “No heparin products in any dose should be given.”
30 Apr, 2021 | 08:25h | UTCNews release: Guidance on treatment for rare blood clots and low platelets related to COVID-19 vaccine – American Heart Association
Review: COVID-19-associated coagulopathy and antithrombotic agents – In non-critically ill hospitalized patients, therapeutic dose anticoagulation may improve clinical outcomes. In critically ill patients, this same treatment does not improve outcomes, and prophylactic dose anticoagulation is recommended
29 Apr, 2021 | 08:46h | UTCRelated: Full-dose Heparin best for moderate COVID-19 regardless of D-dimer — Data released from ACTIV-4a, ATTACC, and REMAP-CAP trials AND RCT: Intermediate-dose enoxaparin (1 mg/kg/d) not better than standard-dose prophylactic anticoagulation in patients with Covid-19 admitted to the intensive care unit
Commentary on Twitter
???State of the Art Review Article @TheLancetHaem by @MiddeldorpS
COVID-19-associated coagulopathy
Excellent explanation for the pathophysiology and great summary for the major RCTs and clinical guidelines https://t.co/NxP06KP2Hm pic.twitter.com/qHzyDsUZpt— Antibiotic Steward??Bassam Ghanem (@ABsteward) April 28, 2021
M-A: Extended thromboprophylaxis after hospital discharge for medically ill patients with cancer – Extended thromboprophylaxis is not associated with a reduced rate of venous thromboembolic events and is associated with increased risk of hemorrhage
29 Apr, 2021 | 08:28h | UTC
Systematic Review: Disease‐modifying treatments for primary autoimmune hemolytic anemia
28 Apr, 2021 | 08:09h | UTCDisease‐modifying treatments for primary autoimmune haemolytic anaemia – Cochrane Library
Summary: Treatment for primary autoimmune haemolytic anaemia – Cochrane Library
RCT: Reduced dose direct oral anticoagulants may be a safer option to vitamin K antagonists in hemodialysis patients with atrial fibrillation
27 Apr, 2021 | 09:27h | UTCSafety and Efficacy of Vitamin K Antagonists versus Rivaroxaban in Hemodialysis Patients with Atrial Fibrillation: A Multicenter Randomized Controlled Trial – Journal of the American Society of Nephrology (link to abstract – $ for full-text)
Commentary on Twitter
This study finds that patients on hemodialysis with atrial fibrillation experienced decreased cardiovascular events and major bleeding complications with direct oral anticoagulants compared with vitamin K antagonists https://t.co/6FOKkEXtfN pic.twitter.com/PD6qHaeZjT
— JASN_News (@JASN_News) March 22, 2021
ISTH Interim Guidance for the Diagnosis and Treatment on Vaccine Induced Immune Thrombotic Thrombocytopenia
21 Apr, 2021 | 07:11h | UTCSee also: Diagnostic Flow Chart
Commentary on Twitter
The ISTH has released interim guidance on vaccine-induced immune thrombotic thrombocytopenia (#VITT) to inform the management of suspected thrombosis in subjects who have recently received the AstraZeneca or Johnson & Johnson vaccine. https://t.co/qqtQtpywaf pic.twitter.com/wNmjNNDs4z
— ISTH (@isth) April 20, 2021
COVID-19 Vaccine Janssen: EMA finds possible link to very rare cases of unusual blood clots with low blood platelets
21 Apr, 2021 | 07:07h | UTCCommentary: Johnson & Johnson vaccine: EU regulator says blood clot very rare side effect – BBC
Commentary on Twitter
EMA has concluded there is a possible link between TTS (thrombosis & thrombocytopenia syndrome) & the J&J vaccine, & they will be adding it as a rare side effect to the product information: the same as for AZ, but so far reported at a much lower rate…1/n https://t.co/aonOEObeHR
— Hilda Bastian, PhD (@hildabast) April 20, 2021
Vaccine-induced Immune Thrombotic Thrombocytopenia: Frequently Asked Questions
21 Apr, 2021 | 07:09h | UTC
M-A: Guided versus standard antiplatelet therapy in patients undergoing percutaneous coronary intervention
20 Apr, 2021 | 05:40h | UTC
Commentary on Twitter
Great paper on guided vs standard DAPT.
Interestingly outcomes were found to vary according to the strategy used:
ESCALATION was associated with⬇️ISCHEMIC EVENTS (without⬆️bleedings)
DE-ESCALATION was associated with⬇️ BLEEDINGS (without ⬆️ischemic events). https://t.co/y4ys6tvktw— Gregory A. Sgueglia (@GregorySgueglia) April 16, 2021
Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination
18 Apr, 2021 | 21:43h | UTCCommentaries: Researchers Offer Algorithm for Managing Thrombosis and Thrombocytopenia After COVID-19 Vaccination – NEJM Journal Watch AND Blood Clots After COVID-19 Vaccination Linked to Immune Response: UK Report – TCTMD AND People with rare blood clots after a COVID-19 jab share an uncommon immune response – ScienceNews