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Anticoagulation in Patients With COVID-19: JACC Review Topic of the Week.
Farkouh, Michael E; Stone, Gregg W; Lala, Anuradha; Bagiella, Emilia; Moreno, Pedro R; Nadkarni, Girish N; Ben-Yehuda, Ori; Granada, Juan F; Dressler, Ovidiu; Tinuoye, Elizabeth O; Granada, Carlos; Bustamante, Jessica; Peyra, Carlos; Godoy, Lucas C; Palacios, Igor F; Fuster, Valentin.
  • Farkouh ME; Peter Munk Cardiac Centre, University of Toronto, Toronto, Ontario, Canada; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Stone GW; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; The Cardiovascular Research Foundation, New York, New York, USA.
  • Lala A; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Bagiella E; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Moreno PR; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Nadkarni GN; The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York, USA.
  • Ben-Yehuda O; The Cardiovascular Research Foundation, New York, New York, USA; Columbia University Medical Center, New York, New York, USA.
  • Granada JF; The Cardiovascular Research Foundation, New York, New York, USA; Columbia University Medical Center, New York, New York, USA.
  • Dressler O; The Cardiovascular Research Foundation, New York, New York, USA.
  • Tinuoye EO; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Granada C; Cogent Technologies Corporation, Mahwah, New Jersey, USA.
  • Bustamante J; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Peyra C; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Godoy LC; Peter Munk Cardiac Centre, University of Toronto, Toronto, Ontario, Canada.
  • Palacios IF; Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
  • Fuster V; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain. Electronic address: valentin.fuster@mountsinai.org.
J Am Coll Cardiol ; 79(9): 917-928, 2022 03 08.
Article in English | MEDLINE | ID: covidwho-1706820
ABSTRACT
Clinical, laboratory, and autopsy findings support an association between coronavirus disease-2019 (COVID-19) and thromboembolic disease. Acute COVID-19 infection is characterized by mononuclear cell reactivity and pan-endothelialitis, contributing to a high incidence of thrombosis in large and small blood vessels, both arterial and venous. Observational studies and randomized trials have investigated whether full-dose anticoagulation may improve outcomes compared with prophylactic dose heparin. Although no benefit for therapeutic heparin has been found in patients who are critically ill hospitalized with COVID-19, some studies support a possible role for therapeutic anticoagulation in patients not yet requiring intensive care unit support. We summarize the pathology, rationale, and current evidence for use of anticoagulation in patients with COVID-19 and describe the main design elements of the ongoing FREEDOM COVID-19 Anticoagulation trial, in which 3,600 hospitalized patients with COVID-19 not requiring intensive care unit level of care are being randomized to prophylactic-dose enoxaparin vs therapeutic-dose enoxaparin vs therapeutic-dose apixaban. (FREEDOM COVID-19 Anticoagulation Strategy [FREEDOM COVID]; NCT04512079).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thromboembolism / Thrombosis / COVID-19 / Anticoagulants Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: J Am Coll Cardiol Year: 2022 Document Type: Article Affiliation country: J.jacc.2021.12.023

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thromboembolism / Thrombosis / COVID-19 / Anticoagulants Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: J Am Coll Cardiol Year: 2022 Document Type: Article Affiliation country: J.jacc.2021.12.023