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The impacts of prophylactic anticoagulation therapy during hospitalization on long-term cardiovascular outcomes in
Jun Gu1, Yue Wang1, Jun-Feng Zhang1
1Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
International Journal of Cardiology. Heart & Vasculature
|February 13, 2024
Summary
Prophylactic anticoagulation therapy significantly reduced major adverse cardiovascular events (MACEs) in high-risk COVID-19 patients during the omicron wave. This therapy proved effective in preventing cardiovascular death, heart attack, stroke, and thrombosis.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Severe COVID-19 patients may benefit from prophylactic anticoagulation.
- Long-term cardiovascular outcomes and major adverse cardiovascular events (MACEs) in high-risk patients during the omicron wave remain unclear.
Purpose of the Study:
- To evaluate the long-term effects of prophylactic anticoagulation therapy on MACEs in hospitalized COVID-19 patients with cardiovascular risk factors or pre-existing cardiovascular diseases during the omicron wave.
Main Methods:
- Prospective cohort study of hospitalized COVID-19 patients (April-June 2022).
- Propensity score matching (PSM) used to compare outcomes between patients who received anticoagulants and those who did not.
- MACEs included: cardiovascular death, myocardial infarction, stroke, unstable angina, coronary revascularization, and arterial or venous thrombosis.
Main Results:
- Two matched cohorts of 230 patients each were formed.
- Over 15 months, 13 patients on anticoagulants and 29 controls experienced MACEs.
- Anticoagulation significantly lowered MACE risk (HR 0.431; P=0.010), primarily by reducing thrombosis. Benefits were noted in older adults, women, and unvaccinated patients.
Conclusions:
- Prophylactic anticoagulation during hospitalization effectively reduces long-term MACEs in COVID-19 patients with cardiovascular risks.
- This strategy is beneficial amidst the omicron variant pandemic waves.
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