A randomized controlled trial to investigate the use of acute coronary syndrome therapy in patients hospitalized with COVID-19: the COVID-19 Acute Coronary Syndrome trial
J. thromb. haemost
; 21: 2213-2222, Apr. 2023. graf, ilus, tab
Article
in En
| CONASS, SES-SP, SESSP-IDPCPROD, SES-SP
| ID: biblio-1435649
Responsible library:
BR79.1
ABSTRACT
BACKGROUND:
patients hospitalised with covid-19 suffer thrombotic complications. risk factors for poor outcomes are shared with coronary artery disease.Objectives:
to investigate efficacy of an acute coronary syndrome regimen in patients hospitalised with covid-19 and coronary disease risk factors. PATIENTS/METHODS:
a randomised controlled open-label trial across acute hospitals (uk and brazil) added aspirin, clopidogrel, low-dose rivaroxaban, atorvastatin, and omeprazole to standard care for 28-days. primary efficacy and safety outcomes were 30-day mortality and bleeding. the key secondary outcome was a daily clinical status (at home, in hospital, on intensive therapy unit admission, death).RESULTS:
320 patients from 9 centres were randomised. the trial terminated early due to low recruitment. at 30 days there was no significant difference in mortality (intervention 11.5% vs control 15%, unadjusted or 0.73, 95%ci 0.38 to 1.41, p=0.355). significant bleeds were infrequent and not significantly different between the arms (intervention 1.9% vs control 1.9%, p>0.999). using a bayesian markov longitudinal ordinal model, it was 93% probable that intervention arm participants were more likely to transition to a better clinical state each day (or 1.46, 95% cri 0.88 to 95 2.37, pr(beta>0) =93%; adjusted or 1.50, 95% cri 0.91 to 2.45, pr(beta>0) =95%) and median time to discharge home was two days shorter (95% cri -4 to 0, 2% probability that it was worse).CONCLUSIONS:
acute coronary syndrome treatment regimen was associated with a 99 reduction in the length of hospital stay without an excess in major bleeding. a larger trial is needed to evaluate mortality.
Full text:
1
Collection:
06-national
/
BR
Health context:
1_ASSA2030
/
2_ODS3
/
4_TD
/
6_ODS3_enfermedades_notrasmisibles
Database:
CONASS
/
SES-SP
/
SESSP-IDPCPROD
Main subject:
Acute Coronary Syndrome
/
COVID-19
Type of study:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
J. thromb. haemost
Year:
2023
Document type:
Article