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没有确定高风险子组在COVID-19住院后受益于血栓预防治疗
Lisa Baumann Kreuziger1,2, Taeim Kwon3, Raj S Kasthuri4
1Versiti Blood Research Institute, Milwaukee, Wisconsin, USA.
Research and practice in thrombosis and haemostasis
|June 11, 2024
概括
在ACTIV-4c试验中发现,预防性阿皮克萨班在大多数COVID-19幸存者中没有显著减少死亡或血栓塞栓症. 虽然老年患者 (>60) 显示了益处的趋势,但没有高危子组明显受益于延长血栓预防.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 加快COVID-19治疗干预和疫苗-4c (ACTIV-4c) 试验评估了COVID-19住院后30天的预防性阿皮克萨班.
- 出院后早期死亡或血栓栓塞发生率较低,导致试验提前结束.
研究的目的:
- 为了确定高风险的COVID-19患者子组,可能受益于离院后的血栓预防治疗.
- 小组分析包括年龄,种族/种族,肥胖,D-二次数水平,WHO评分和修改的M-PREVENT评分.
主要方法:
- 分析了30天内所有死因,动脉血栓栓塞 (ATE) 和静脉血栓塞 (VTE) 的累积发病率.
- 考克斯比例危险模型与相互作用测试被用于分析到主要终点事件的时间.
主要成果:
- 总体30天复合终点发生率为2.13% (阿皮克萨班) 与2.31% (安慰剂).
- 在各个子组中发生了类似的事件率,在60岁以上的患者中,益处的趋势不显著.
- 没有一个子组表明阿皮克萨班对血栓预防有明显的益处.
结论:
- 在COVID-19幸存者中,30天死亡,ATE和VTE的发生率很低,除了可能在60岁以上的人中.
- 有限的事件使得研究结果不确切,但没有一个高风险小组明显受益于延长血栓预防.
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