Recent Randomized Trials of Antithrombotic Therapy for Patients With COVID-19: JACC State-of-the-Art Review

Endothelial injury and microvascular/macrovascular thrombosis are common pathophysiological features of coronavirus disease-2019 (COVID-19). However, the optimal thromboprophylactic regimens remain unknown across the spectrum of illness severity of COVID-19. A variety of antithrombotic agents, doses...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2021-04, Vol.77 (15), p.1903
Main Authors: Talasaz, Azita H, Sadeghipour, Parham, Kakavand, Hessam, Aghakouchakzadeh, Maryam, Kordzadeh-Kermani, Elaheh, Van Tassell, Benjamin W, Gheymati, Azin, Ariannejad, Hamid, Hosseini, Seyed Hossein, Jamalkhani, Sepehr, Sholzberg, Michelle, Monreal, Manuel, Jimenez, David, Piazza, Gregory, Parikh, Sahil A, Kirtane, Ajay J, Eikelboom, John W, Connors, Jean M, Hunt, Beverley J, Konstantinides, Stavros V, Cushman, Mary, Weitz, Jeffrey I, Stone, Gregg W, Krumholz, Harlan M, Lip, Gregory Y H, Goldhaber, Samuel Z, Bikdeli, Behnood
Format: Article
Language:English
Subjects:
COVID-19 - complications
COVID-19 - drug therapy
Fibrinolytic Agents - therapeutic use
Humans
Randomized Controlled Trials as Topic
Thromboembolism - prevention & control
Thromboembolism - virology
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Summary:Endothelial injury and microvascular/macrovascular thrombosis are common pathophysiological features of coronavirus disease-2019 (COVID-19). However, the optimal thromboprophylactic regimens remain unknown across the spectrum of illness severity of COVID-19. A variety of antithrombotic agents, doses, and durations of therapy are being assessed in ongoing randomized controlled trials (RCTs) that focus on outpatients, hospitalized patients in medical wards, and patients critically ill with COVID-19. This paper provides a perspective of the ongoing or completed RCTs related to antithrombotic strategies used in COVID-19, the opportunities and challenges for the clinical trial enterprise, and areas of existing knowledge, as well as data gaps that may motivate the design of future RCTs.
ISSN:1558-3597
1558-3597
DOI:10.1016/j.jacc.2021.02.035