Anticoagulation in Patients With COVID-19 JACC Review Topic of the Week

被引：47

作者：

Farkouh, Michael E. ^{[1
,2
]}

Stone, Gregg W. ^{[2
,3
]}

Lala, Anuradha ^{[2
,4
]}

Bagiella, Emilia ^{[4
]}

Moreno, Pedro R. ^{[2
]}

Nadkarni, Girish N. ^{[5
]}

Ben-Yehuda, Ori ^{[3
,6
]}

Granada, Juan F. ^{[3
,6
]}

Dressler, Ovidiu ^{[3
]}

Tinuoye, Elizabeth O. ^{[2
]}

Granada, Carlos ^{[7
]}

Bustamante, Jessica ^{[2
]}

Peyra, Carlos ^{[2
]}

Godoy, Lucas C. ^{[1
]}

Palacios, Igor F. ^{[8
,9
]}

Fuster, Valentin ^{[2
,10
]}

机构：

[1] Univ Toronto, Peter Munk Cardiac Ctr, Toronto, ON, Canada

[2] Icahn Sch Med Mt Sinai, Zena & Michael Wiener Cardiovasc Inst, 1 Gustave Levy Pl,Box 1030, New York, NY 10029 USA

[3] Cardiovasc Res Fdn, New York, NY USA

[4] Icahn Sch Med Mt Sinai, Dept Populat Hlth Sci & Policy, New York, NY 10029 USA

[5] Hasso Plattner Inst Digital Hlth Mt Sinai, New York, NY USA

[6] Columbia Univ, Med Ctr, New York, NY USA

[7] Cogent Technol Corp, Mahwah, NJ USA

[8] Massachusetts Gen Hosp, Boston, MA 02114 USA

[9] Harvard Med Sch, Boston, MA 02115 USA

[10] Ctr Nacl Invest Cardiovasc, Madrid, Spain

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2022年 / 79卷 / 09期

基金：

加拿大健康研究院;

关键词：

anticoagulation; clinical trial; coagulopathy; COVID-19; CORONAVIRUS DISEASE 2019; THROMBOSIS; MORTALITY; OUTCOMES;

D O I：

10.1016/j.jacc.2021.12.023

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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) (c) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

引用

页码：917 / 928

页数：12

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