Risk of intracranial hemorrhage between different direct oral anticoagulants in older patients seen in the emergency department with a head injury: A population-based cohort study

Thrombosis Research
Canadian retrospective study (n=9230; 5.9% with intracranial haemorrhage) found no differences in the risk of intracranial haemorrhage between DOACs (dabigatran vs rivaroxaban; dabigatran vs apixaban; rivaroxaban vs apixaban) and matched cohorts.

A multinational European network to implement integrated care in elderly multimorbid atrial fibrillation patients: the AFFIRMO Consortium

European Heart Journal
This consortium will provide new evidence on specific care models, including risk stratification tools for patients with polypharmacy, which will help to improve clinical management and reduce the risks of major clinical adverse outcomes.

Risk of venous thromboembolism in men with prostate cancer compared with men in the general population: a nationwide population-based cohort study in Sweden

BMJ Open
Swedish study (n=92,105 with prostate cancer, n=466,241 without prostate cancer) found men with prostate cancer had a mean 50% increased risk of VTE during the 5 years following cancer diagnosis vs men without prostate cancer. DVT accounted for 52% of VTE cases in both cohorts.

COMPASS open label extension study results support the long-term use of rivaroxaban (Xarelto®) plus aspirin for vascular protection in patients with chronic Coronary Artery Disease (CAD) and/or Peripheral Artery Disease (PAD)

Biospace Inc.
COMPASS LTOLE study (n=12,964) found rivaroxaban 2.5 mg twice daily + aspirin 75-100 mg daily for up to 3 years was linked to similar/lower incidence rates for major CV events (2.35 vs 2.18/100 patient yrs) & bleeding (1.01 vs 1.67/100 patient yrs) vs randomised treatment phase.

Apixaban or Warfarin and Aspirin or Placebo After Acute Coronary Syndrome or Percutaneous Coronary Intervention in Patients With Atrial Fibrillation and Prior Stroke - A Post Hoc Analysis From the AUGUSTUS Trial

JAMA Cardiology
In this analysis of the subgroup of patients with a history of atrial fibrillation or stroke apixaban was associated with a lower risk of bleeding, death, or hospitalization than warfarin. Patients treated with aspirin had a higher bleeding risk than those receiving placebo.

The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:

http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services

Venous or arterial thrombosis and deaths among COVID-19 cases: a European network cohort study

The Lancet Infectious Diseases
Study (n=909 473; 32 329 hospitalised) found occurrence of venous thromboembolism in patients with COVID-19 was associated with increased mortality (adjusted HRs 4.42 for not hospitalised and 1.63 for hospitalised), as was occurrence of arterial thromboembolism (3.16 and 1.93).

Apixaban vs. standard of care after transcatheter aortic valve implantation: the ATLANTIS trial

European Heart Journal
RCT (n=1500) found that after transcatheter aortic valve implantation, apixaban was not superior to standard of care (a vitamin K antagonist or antiplatelet), irrespective of an indication for oral anticoagulation (primary efficacy endpoint HR 0.92; 95% CI 0.73–1.16).

The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:

http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services

Association of bleeding severity with mortality in extended thromboprophylaxis of medically ill patients in the MAGELLAN and MARINER trials

Circulation
Post hoc analysis of rivaroxaban studies found all-cause mortality (ACM) for patients with nonmajor clinically relevant bleeding (BL) vs. no BL not increased in MARINER (HR 0.43;P=0.235) but increased in MAGELLAN (1.74;P=0.021). Major BL was not linked to higher ACM incidence.

Small volume intramuscular injections in people taking oral anticoagulants

Specialist Pharmacy Service
This resource covers guidance and evidence, practical advice for healthcare professionals, product prescribing information, advice on vaccines, including influenza and covid-19, and includes section on injecting hydroxocobalamin subcutaneously, and possible alternatives.

The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:

http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services